| 12/15/2023 | 90181990 | 989803104151 COMFORT CARE CUFF, PEDIATRIC (M1572A) 90 | XXXXXXXXXX | 1 | NOS | 15.82 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803206591 AIRWAY ADAPTOR REUSABLE ADULT/PEDIATRIC 90 | XXXXXXXXXX | 2 | NOS | 173.89 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803206591 AIRWAY ADAPTOR REUSABLE ADULT/PEDIATRIC 90 | XXXXXXXXXX | 2 | NOS | 212.35 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803206591 AIRWAY ADAPTOR REUSABLE ADULT/PEDIATRIC 90 | XXXXXXXXXX | 10 | NOS | 929.08 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803206591 AIRWAY ADAPTOR REUSABLE ADULT/PEDIATRIC 90 | XXXXXXXXXX | 2 | NOS | 185.05 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803104141 COMFORT CARE CUFF, INFANT (M1571A) 90 | XXXXXXXXXX | 1 | NOS | 8.92 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803104141 COMFORT CARE CUFF, INFANT (M1571A) 90 | XXXXXXXXXX | 5 | NOS | 46.03 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803104141 COMFORT CARE CUFF, INFANT (M1571A) 90 | XXXXXXXXXX | 2 | NOS | 16.33 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803206591 AIRWAY ADAPTOR REUSABLE ADULT/PEDIATRIC 90 | XXXXXXXXXX | 2 | NOS | 198.56 | COSTA RICA | DELHI ACC |
| 12/15/2023 | 90181990 | 989803206591 AIRWAY ADAPTOR REUSABLE ADULT/PEDIATRIC 90 | XXXXXXXXXX | 29 | NOS | 3169.53 | COSTA RICA | DELHI ACC |