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Over time, they may begin to appear darker with a yellowish or grey tinge due to stains on the surface

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As the cells keep growing, they form tumours

Accordingly, CMS would only permit ACOs that are currently participating in the Shared Savings Program, that have earned shared savings in the most recent performance year for which financial reconciliation has been completed, and that have a positive prior savings adjustment at application disposition to receive prepaid shared savings, as they have the history of success that provides CMS with a more reasoned expectation that they will earn shared savings in the future

State tobacco taxes drive most of this variation, ranging from as low as $0.17 per pack to over $4.00 per pack

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