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ST MARYS HOSPITAL DECATUR OF HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS · HC MRI BRAIN W/O CONTRAST
$4,115.52
Source file dated 2026-03-25 · both
Source note: 55% of $5,716.00 in Billed Charges for Rev 610 Proc 70551 = $3,143.80. Percent of Charge CDM service is reimbursed at a line level and those calculations will not change from person to person.
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