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If not neutralized by antioxidants, ROS may damage mitochondria over time, causing them to function less efficiently and to generate more damaging ROS in a self-perpetuating cycle

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This change to the proposal to use both the existing E/M services approach and the proposed Covered Professional Services approach will give us the opportunity to monitor the effects of each approach, particularly the use of E/M services in our QP determination methodology, to ensure that our methodology reflects and rewards meaningful participation in Advanced APMs