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Document all reconstitution and storage conditions per laboratory quality standards

Without L-carnitine, these dietary fats cannot enter the mitochondrial matrix to undergo beta-oxidation, the biochemical process that breaks down fats to generate adenosine triphosphate (ATP), the universal energy currency of the human body

Formation of the most uncommon kidney stones, cystine stones, also occurs in acidic urine (Frassetto 2011)

Tirzepatide concentration and volume chart Compounded tirzepatide comes in several concentrations

- **Retatrutide vial** (lyophilized powder -- usually a white cake or powder at the bottom) - **Bacteriostatic water (BAC water)** -- NOT sterile water unless using single-dose - **3ml syringe with needle** for drawing BAC water - **Insulin syringes** (29-31 gauge, 1/2 inch) for injections - **Alcohol swabs** (70% isopropyl) - **Clean, flat work surface** with good lighting - **Sharps container** for needle disposal ### Know Your Vial Compounded retatrutide commonly comes in these sizes: - **30mg** -- Good for patients on lower doses (1-4mg)

Specifically, we proposed that the Emergency Care Access & Timeliness eCQM would not be required to be reported by REHs under the REHQR Program, but that REHs must elect to report either the Emergency Care Access & Timeliness eCQM or the Median Time for Discharged ED Patients measure to meet program requirements, beginning with the CY 2027 reporting period/CY 2029 program determination