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Decreased vitamin B12 absorption due to altered gut microbiota Potential for megaloblastic anemia in prolonged use Increased risk of neuropathy and other neurological complications Dose and Duration Considerations The risk of B12 deficiency with metformin depends on the dose and how long you take it

Step One: Standardize the Median Payer-Specific Negotiated Charges: In order to make the median payer-specific negotiated charges from the cost reports more comparable among hospitals, we would standardize the median payer-specific negotiated charges reported on the cost report by removing the effects of differences in area wage levels, and cost-of living adjustments for hospital claims from Alaska and Hawaii, in the same manner as under the current MS-DRG relative weight calculation for those effects

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