Thank you for viewing ( .ˬ.)" * Medical Information Management Specialist Education Practice Questions 2023, Specialized Course Edition Useful for certification exam preparation. All pencil markings have been erased. There are some highlighted sections as shown in the photos. I don't think it will interfere with solving the problems. There are some scratches and stains on the cover from carrying it around. Please understand. If you have any questions, feel free to ask ♪ Instant purchase OK