One of the main conditions that HRSA hopes to handle through these auditing requirements relates to duplicate special discounts that occur whenever a producer rebate is normally redeemed for a medication that has currently been discounted beneath the 340B program. Pharmacy Times Health-Program Edition Editor Stephen Eckel, PharmD, MHS, FASHP, FAPhA, previously wrote that the need for even more stringent audits is probable the consequence of 2010 suggestions that allowed for the establishment of multiple contract pharmacies with 1 protected entity, which led some institutions to contract with chain drug stores directly.Of these, 7460 patients were excluded, most commonly because of diffusely diseased or little coronary arteries , a doctor who was simply not participating in the study or a coordinator who was simply unavailable to enroll the patient , and the unwillingness or inability of the patient to supply consent . More excluded sufferers than enrolled individuals experienced chronic obstructive pulmonary disease , renal insufficiency , peripheral vascular disease , hypertension , and previous CABG . Enrolled individuals had a lesser predicted risk of death before discharge or within thirty days after the procedure than those that were excluded . About 15 percent of enrolled individuals had been categorized as having urgent position however, not requiring immediate surgery. Overall, 2203 patients had been randomly assigned to either on-pump surgery or off-pump surgery .