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In addition, because reconciling a rebate amount imposes substantial administrative burden on CMS to reprocess the rebate amount, retest the reporting system, and reissue a Rebate Report, CMS proposes in 428.401(d)(2) that it may exercise discretion not to initiate recalculation of the rebate amount in these situations which are outside of the regular reconciliation process proposed in 428.401(d)(1)

Native Americans in both North and South America chewed the fresh leaves of the tobacco plant, frequently mixed with lime