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The commenter opined that treating urban hospitals re-designated as rural under 412.103 the same as geographically rural hospitals for the calculation of the rural wage index and rural floor is an appropriate and fair implementation of the statute

Extracellular nucleotides were extracted by adding 200 L acetonitrile (ACN), followed by centrifugation

The intrinsic factor complication adds another layer

The EFSA notes, The inherent uncertainty of this [factorial] approach is reflected in the wide range of cobalamin intake calculated to compensate for estimated daily losses, depending on the assumptions taken (EFSA, 2015). Appendix D