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For example, in a 16-week, placebo-controlled trial of an age-advanced cohort receiving nightly subcutaneous GHRH analogue (a sermorelin-like peptide), treatment activated endogenous GH pulsatility and significantly increased integrated nocturnal GH levels

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of the preamble of this proposed rule, this policy was applied in FYs 2020 through 2023, and we are proposing to continue to apply this policy in FY 2024