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    MMRV Evaluation (MSL, MUMP, RUB, VZ)
    1 X $95.00 = $95.00
    Culture, Mycobacteria (AFB)
    1 X $48.00 = $48.00
    Rubella Immune Status
    1 X $32.00 = $32.00
    Subtotal $175.00
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