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If it is not flowing smoothly, or not flowing at all, it could be because the needle is not positioned well under the skin

For the first performance year in the current agreement period, the ACO's prepaid shared savings multiplier will be recalculated for changes in per capita shared savings or losses for the performance years that constitute BY1 or BY2 and that are used in the calculation of the prepaid shared savings multiplier as a result of issuance of a revised initial determination under 425.315

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This preemptive step can help mitigate the dehydrating effects of alcohol