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Individual who uses such a drug or biological means a unique Medicare Part B beneficiary who was furnished the Part B drug or biological that was covered under Part B during the applicable calendar quarter, identified using final action claims data with dates of service during the calendar year described in 427.101(b)(6) and with allowed charges greater than zero

In the context of ICD-10 codes, nicotine dependence is not an illness or an injury

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If the average total allowed charges for a year per individual who uses such drug or biological product are less than the applicable threshold, CMS proposes to exclude the billing and payment code for that calendar quarter