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You could even bump those graphics up to high bruh. The only issue i ever get with my pc is running fallout 4 on ultra graphics when in the middle of a highly populated area (such as downtown Boston) that leads to very noticeable lag. I personally think it's more of a software thing being that Fallout 4 trys to load everything in your immediate area even if you are not looking directly at certain things, in extremely dense locations (like aforementioned) it ends up being a lot of work on the cpu rendering stuff thats not directly in player view.
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