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Product	Price	Quantity	Subtotal	Remove
OTH-017 Oral Cavity Cover (Transparent)	$55.00	OTH-017 Oral Cavity Cover (Transparent) quantity	$55.00	×
STD28F-UPLA ADEM Base, 28 Tooth with Soft Tissue	$185.50	STD28F-UPLA ADEM Base, 28 Tooth with Soft Tissue quantity	$185.50	×
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Subtotal	$240.50
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State Tax	$17.44
Total	$257.94