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Major vessels were congested (i.e., inferior caval vein, superior mesenteric vein), azygos vein collapsed, venous and arterial thrombosis progressed, peripherally and centrally, and advanced Virchow triad was fully substantiated

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As stated in the CY 2025 PFS proposed rule (89 FR 61959), we explained that civil money penalties are a point-in-time penalty tied to the rebate amount due at the applicable payment deadline, which occurs 30 days after the date of receipt of a Rebate Report