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We estimate a maximum annual change of minus $655,228.02 [(3,181.602 hr $107.66/hr = $342,531.06 for computer system analysts) + (1,164 hr $132.44/hr = $154,160.16 for medical and health service managers) + (388 hr $61.68/hr = $23,931.84 for LPNs) + (388 hr $47.60/hr = $18,468.80 for billing clerks) + (388 hr $299.32/hr = $116,136.16 for physicians)]