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With regard to measure reporting, we estimate the removal of this measure will decrease burden for voluntary reporting for the CY 2025 reporting period by 383 hours (4,590 ASCs 50 percent of ASCs 0.167 hours per ASC) at a savings of $21,088 (383 hours $55.06/hour) and 765 hours annually (0.167 hours 4,590 ASCs) at a savings of $42,121 (765 hours $55.06/hour) for mandatory reporting beginning with the CY 2026 reporting period

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Reasons for exclusion were previous vitamin B12 injections within 12 months before the reference date (26 cases), documented alcohol abuse (16 cases), undergoing chemotherapy or hormonal therapy for a malignancy (9 cases), and no documentation that vitamin B 12 therapy was initiated (7 cases)