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The patients anemia is due to chronic kidney disease stage 4. This link is the difference between a paid claim and a denied claim

[DOI] [PubMed] [Google Scholar] 5.Kuzminski AM, Del Giacco EJ, Allen RH, Stabler SP, Lindenbaum J

5-amino-1MQ (5-amino-1-methylquinolinium iodide) is a small-molecule selective inhibitor of nicotinamide N-methyltransferase (NNMT), the enzyme that methylates nicotinamide using S-adenosylmethionine (SAM)