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We note that section 1833(t)(3)(F) of the Act provides that application of this subparagraph may result in the OPD fee schedule increase factor under section 1833(t)(3)(C)(iv) of the Act being less than 0.0 percent for a year and may result in OPPS payment rates being less than rates for the preceding year

Limitations include: Enzymatic and chemical degradation Poor membrane permeability Comparatively large molecular size When a peptide like epithalon is unmodified, bioavailability may be less than 1%

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