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CRC-DR
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EFTA00599985.pdf
1 mentionEFTA00599985
or New York NY 10022 Date Account 11/24/2010 9649 Remittance IMPORTAIC • PLEASE DETACH UPPER PORTION AND RETURN WITH YOLK REmITTANDE TO INSURE CRC-DR TO PROPER ACCOLAIT Date Patient Description Charges Credits Balance Previous Balance 0.00 11/24/2010 Comprehensive Oral oval 50.00 50.00
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