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As you pointed out, 200 and some odd billion-dollar business

In determining whether a service is subject to the provisions of section 1834(m) of the Act, we therefore review during this Step 2 whether one or more of the elements of the service, as described by the particular HCPCS code at issue, ordinarily involve direct, face-to-face interaction between the patient and practitioner such that the use of an interactive telecommunications system to deliver the service would be a substitute for an in-person visit

However, it doesn't harm the tobacco if you crush it further to suit your taste

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And our readings show that the global mean temperature has risen about point four degrees in the three-decade period