| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 10 | UNIT | 196 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 20 | UNIT | 335 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 15 | UNIT | 616 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 3 | UNIT | 73 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 8 | UNIT | 328 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 10 | UNIT | 129 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 10 | UNIT | 124 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 15 | UNIT | 616 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 15 | UNIT | 333 | POLAND | NA |
| 3/22/2024 | 902139900014 | DENTAL PROSTHESIS (PORCELAIN CROWN/ZIRCONIUM K/RON/DIVISIONAL PROSTHESIS/TELESCOPE CRON) | XXXXXXXXXX | 3 | UNIT | 143 | POLAND | NA |