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OCR: Patient roscects 1200 1588 htiv Duote Claim History "Retund review Hicton Apply Managee $1,400.00 $0.00 10.00 $1,400.0 $5.376.00 $0.00 0.00 $0.00 $5,376.00 >1050 $1,928.00 t0.0 00 $0.0 $1,928.00 CHKHND