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B12 deficiency is one of the most common and most frequently overlooked nutritional deficiencies, affecting those on plant-based diets, adults over 50, individuals on certain medications, and anyone with reduced gastrointestinal absorption

Additionally, the FDA recommends that these medications not be taken during pregnancy and be discontinued at least two months prior to pregnancy, because studies in rats, rabbits, and monkeys demonstrated that animals treated with these medications had higher rates of miscarriage, were born smaller, and were more likely to have birth defects

This is consistent with NOS block preventing the beneficial effect of RPc on no-reflow in vivo 29

Coders see the gap before the claim leaves the practice, not after the denial returns weeks later