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ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC HOSPITAL SISTERS · HC MRI BRAIN W/O CONTR SHUNT EVAL LIMITED
$372.90
Source file dated 2026-03-24 · both
Source note: 100% of $565.00 in Billed Charges for Rev 610 Proc 70551 = $565.00. 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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