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Individuals at risk of vitamin B12 deficiency include older adults, people with gastrointestinal disorders, those who have had gastrointestinal surgeries, individuals on a strict vegan diet, individuals who take metformin for blood sugar control, and people taking proton pump inhibitors for chronic heartburn

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Strengths and limitations of this case Strengths 1

For example, to determine the reduced national unadjusted payment rates that applied to hospitals that failed to meet their quality reporting requirements for the CY 2010 OPPS/ASC final rule with comment period, we multiplied the final full national unadjusted payment rate found in Addendum B of the CY 2010 OPPS/ASC final rule with comment period by the CY 2010 OPPS final rule with comment period reporting ratio of 0.980 (74 FR 60642)

Overdose of B12 can cause anxiety, acne, skin redness, headache, nausea, vomiting, heart stroke, face paralysis, palpitations, facial ruddiness, and insomnia