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    Arjo, First Step Cirrus Low Air Loss System Remove
    Arjo, First Step Cirrus Low Air Loss System
    2 X $10,249.00 = $20,498.00
    HealthCraft, SuperBar Add On Kit, SPB-AK Remove
    HealthCraft, SuperBar Add On Kit, SPB-AK
    1 X $192.00 = $192.00
    Drive, Rebel Wheelchair, RTLREB18DDA-SF Remove
    Drive, Rebel Wheelchair, RTLREB18DDA-SF
    1 X $380.00 = $380.00
    ObusForme, Airfoam Contour Memory Foam Pillow, PL-AFCT-ST Remove
    ObusForme, Airfoam Contour Memory Foam Pillow, PL-AFCT-ST
    1 X $64.00 = $64.00
    Subtotal $21,134.00
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