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Even a small bubble occupies space in the barrel that displaces medication, which means your actual dose is less than what the plunger position suggests

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In 425.672(d), on the period of adjustment, we specify that CMS will adjust Shared Savings Program calculations for SAHS billing activity identified for CY 2024 or subsequent calendar years when the affected calendar year is either a performance year or a benchmark year, and from the 3 most recent years prior to the start of the ACO's agreement period used in establishing the historical benchmark when such a benchmark is used to reconcile the ACO for a performance year adjusted for SAHS billing activity

If you do that, it should be guided and monitored