This is a set of medical office assistant course materials and related documents from Nichii Gakkan. It's a bundled set. - Set Contents: Medical Office Assistant Course Volumes 1-4, Point Quick Reference Table, My Best Note, Exam Preparation Seminar, personal notes, Medical Point Quick Reference Table, Medical Fee Statement (copy for personal use), 4 Text Supplements, Handbook, and the complete Medical Fee Point Table, totaling 13 items. 2022 edition. Index stickers, sticky notes, writing, and highlighting are all present. There is writing in the practice questions as well. - Publisher: Nichii I studied with these materials and successfully obtained the certification. There are no major folds, but the index stickers are bent.