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ST ANTHONYS MEMORIAL HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS · HC THYROID STIMULATING HORM

$137.52

Source file dated 2026-03-24 · both

Source note: 65.5% of $191.00 in Billed Charges for Rev 301 Proc 84443 = $125.11. 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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