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The tumor mass is surrounded by a massive area of necrosis without inflammatory reaction [2], Fig

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As such, we proposed that, while we would continue to use the first date of sale reported to CMS for most refundable drugs, we would use the date on which the drug is first paid under Part B if the date of first sale as reported to CMS does not adequately approximate the first date of payment under Part B due to an applicable National Coverage Determination (NCD)

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