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Further, we stated in the CY 2024 PFS final rule (88 FR 79062) that we believe that in most cases the JW and JZ modifier requirements impose no new burdens on providers beyond the requirement of measuring and reporting discarded amounts by use of the JW modifier that predates the enactment of the discarded drug refund policy under section 1847A(h) of the Act

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This is on the higher end, which is why many researchers opt for a more conservative fixed dose to begin