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  ProductPriceQuantitySubtotal
× Placeholder Acid phosphatase, total and prostatic fraction 4,100.00
4,100.00
× Placeholder AFP-Alpha Feto Protein 8,400.00
8,400.00
× Placeholder Refraction, Tonometry and Funduscopy (Full Exam) 5,000.00
5,000.00
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Subtotal17,500.00
Total17,500.00