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1515 North Saint Joseph Avenue PO Box 8000 Marshfield WI 54449-8000 1. 800. 472. 2363 715. 221. 9555 TTY 1. L Yes l No There is a presence of significant functional deficit that prohibits or profoundly impairs the ability to perform activities of daily living due to a significant physical deformity or disfigurement resulting from excess skin folds and surgery is expected to restore or greatly improve the functional deficit. The requested service is l Suction-assisted lipectomy The medical...

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