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High dose oral cobalamin may be a suitable alternative in selective cases, where intramuscular injections are not tolerated and compliance is not a problem

We stated in the proposed rule that a requested $9,750 payment from an interested party appeared to be a major outlier for this service, and the range of reported payments in the facility setting reported by the MACs in April 2022 for predecessor CPT code 0398T was $1,554.58 to $2,036.75 when the highest and lowest outliers were removed

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Additionally, the NNMT substrate nicotinamide 12 is metabolized by the microbiome 56,57 , and thus NNMTi may modulate substrate availability, potentially influencing microbial metabolic capacity to drive the NNMTi-mediated weight loss