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Product	Price	Quantity	Subtotal	Remove
OTH-013 Oral Cavity Cover (OCC)	$55.00	OTH-013 Oral Cavity Cover (OCC) quantity	$55.00	×
DS-28 1/2 Mandible Edentulous	$12.00	DS-28 1/2 Mandible Edentulous quantity	$12.00	×
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Subtotal	$67.00
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State Tax	$4.86
Total	$71.86