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Image Product Name Model Quantity Unit Price Total
Revit dragee #80 Revit dragee #80
65    Remove $3.05 $3.05
Sinupret dragee #50 Sinupret dragee #50
579    Remove $20.30 $20.30
Hydrocortison 2,5% 2ml #10 Hydrocortison 2,5% 2ml #10
949    Remove $14.55 $14.55
Aleron 5mg #10 Aleron 5mg #10
1137    Remove $11.15 $11.15

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Sub-Total: $49.05
Total: $49.05