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This is based on the current body of research and our observations of trends in the scientific community

While this methylation reaction was historically considered a relatively minor metabolic pathway for nicotinamide clearance, research over the past decade has revealed that NNMT plays a surprisingly important and previously underappreciated role in cellular energy metabolism, NAD+ homeostasis, adipocyte biology, and whole-body metabolic regulation

Comment: Several commenters cautioned CMS to avoid defaulting to extensions in cases where broader relief is warranted and ensure reporting extensions are not disproportionately utilized in place of exceptions

This represents the amount sufficient to meet the needs of approximately 97% of the population