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    ObusForme, ULTRAFORMETM BACKREST SUPPORT, UF-SDM-MD Remove
    ObusForme, ULTRAFORMETM BACKREST SUPPORT, UF-SDM-MD
    1 X $102.00 = $102.00
    Drive, Seat/Back Sling, 13012 Remove
    Drive, Seat/Back Sling, 13012
    1 X $66.00 = $66.00
    Drive, Digital Patient Lift Scale, 13046-HD Remove
    Drive, Digital Patient Lift Scale, 13046-HD
    1 X $1,750.00 = $1,750.00
    Medline, Drop Arm Bedside Commode, G1-301DX1 Remove
    Medline, Drop Arm Bedside Commode, G1-301DX1
    1 X $165.00 = $165.00
    Drive, Splash Guard, 11107 Remove
    Drive, Splash Guard, 11107
    1 X $5.50 = $5.50
    Subtotal $2,088.50
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