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×		Fecal Occult Blood (In Office Code: 00267, Access>>LC Code: L267)	$55.00	Fecal Occult Blood (In Office Code: 00267, Access>>LC Code: L267) quantity	$55.00
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Subtotal $55.00

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Subtotal	$55.00
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Total	$55.00

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Total $55.00