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3-PIT Sealant Teeth-Green	$4.00	3-PIT Sealant Teeth-Green quantity	$4.00	×
OR-10A Malocclusion Series: Class III (Hard Base)	$96.50	OR-10A Malocclusion Series:Class III (Hard Base) quantity	$96.50	×
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Subtotal	$100.50
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Total	$107.79