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Get CUT0068-4S 2012-2024

Arch 1, 1999 John Doe, M.D. To Richard Roe Professional service rendered $110.00 Missing: Dates, types and levels of service, amount charged for each service, and diagnosis or chief complaint. PRIVATE DUTY NURSING BILL 789 Main Street Hometown, U.S.A. May 4, 1999 To Mrs. Robert Doe Monday 2/7/99 8 AM - 12 AM $40.00 Thursday 2/8/99 8 AM - 12 AM $40.00 $80.00 Service Prescribed by John Roe, M.D. 2/4/99 Emma Jones, RN ’Registration No. 27595 NOTE: Private duty nursing bills must be ac.

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