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Potential risks include glucose intolerance, edema, arthralgia, carpal-tunnel symptoms, elevated IGF-1, hypersensitivity, injection-site reactions, excessive tissue growth, and possible effects on malignancy

there is usually an apparent lack of transparency with quality control

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(v) A statement and, if available, supporting documentation explaining how the hospital satisfies the criterion in paragraph (c)(3) or (d)(3) of this section that it does not discriminate against beneficiaries of Federal health care programs and does not permit physicians practicing at the hospital to discriminate against such beneficiaries