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    Chloride
    1 X $18.00 = $18.00
    Rubella Immune Status
    1 X $32.00 = $32.00
    Insulin, Fasting
    1 X $30.00 = $30.00
    SS-A (RO) Abs
    1 X $41.00 = $41.00
    Subtotal $121.00
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