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He has been using nicotine pouches for the past 4 years, having previously used smokeless tobacco

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We will consider all comments we receive by the date and time specified in the DATES section of this preamble, and, when we proceed with a subsequent document, we will respond to the comments in the preamble to that document

When reopening an initial determination for a performance year pursuant to 425.315, we consider it appropriate to account for the impact of improper payments on expenditures used to establish the ACO's historical benchmark, consistent with our proposal