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(4) Calculation of total Medicare Parts A and B fee-for-service revenue of ACO participants and total Medicare Parts A and B fee-for-service expenditures for the ACO's assigned beneficiaries for purposes of identifying whether an ACO is a high revenue ACO or low revenue ACO, as defined under 425.20, determining an ACO's eligibility to receive advance investment payments according to 425.630, and determining whether an ACO qualifies for a shared savings payment under 425.605(h)

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State tobacco taxes drive most of this variation, ranging from as low as $0.17 per pack to over $4.00 per pack

According to the National Institute on Drug Abuse (NIDA), more than 20 million people in the U.S