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Item Description/Number
Unit
Rate
Qty
Amount

Diopsys® NOVA-VEP and Enfant®


       
Diopsys EEG Electrode
(6020-0001-01 Rev 1)
300/Box
$79.75
 
Diopsys EEG Electrode
(6020-0001-02 Rev 1)
600/Box
$159.50
 
VEP Lead Wire Set 48” (3 wires)
(6015-0003-00)
1 Set
$21.95
 
Thermal Printer Paper, 2 ¼" x 85' roll
(6012-0002-00)
1 Roll
$2.00
 

Diopsys® NOVA-ERG


       
Diopsys ERG Lid Electrode
(6020-0002-01 Rev 2)
20 Box
$232.80
 
Diopsys EEG Electrode
(6020-0001-01 Rev 1)
300/Box
$79.75
 
Diopsys EEG Electrode
(6020-0001-02 Rev 1)
600/Box
$159.50
 
Braided ERG Lead Wire Set (3 Wires)
(6015-0004-01 Rev 1)
1 Set
$48.60
 
Lid Scrub Pads
(6016-0005-00 Rev 1)
30/Box
$10.95
 

Patient Preparation


       
NuPrep EEG Skin Prepping Gel, 4 oz tubes
(6010-0001-01)
3 Tubes
$23.75
 
Ten20 Conductive EEG Paste, 4 oz tubes
(6010-0002-01)
3 Tubes
$19.75
 
Ten20 Conductive EEG Paste, 8 oz jar
(6010-0003-00)
3 Jars
$36.75
 
Non-sterile 8ply Gauze, 2 X 2
(6016-0000-00)
200/Pack
$2.50
 
Non-sterile 8ply Gauze, 4 X 4
(6016-0001-00)
200/Pack
$7.50
 
Prep-Check Electrode Impedance Meter
(6014-0001-01)
1 Meter
$676.50
 

Brochures, Rulers, and Patches


       
Diopsys® NOVA-VEP Patient Brochure "A Window into the Visual Brain"
(5669-0000-02)
50/pack
$6.80
 
Diopsys® NOVA-VEP/ERG Patient Brochure "The Pathway to Visual Health"
(5669-0004-00)
50/pack
$6.80
 
Enfant® Patient Brochure "A new way to protect your child's vision"
(5669-0000-00)
50/pack
$6.80
 
Enfant® Folleto Paciente "Una nueva forma de proteger la vista de los niños"
(5669-0000-01)
50/pack
$6.80
 
Diopsys® NOVA 39" Repositionable Wall Mount Ruler
(5669-0050-01)
1
$15.00
 
Enfant® 36" Repositionable Wall Mount Ruler
(5669-0050-00)
1
$15.00
 
Pirate Patch, 2 ½"Eye Patch w/elastic string
(6013-0001-01)
144/Bag
$23.00
 
Diopsys® Sticker Eye Patch – BLUE TEDDY BEAR
(6013-0002-00)
250/Roll
$40.00
 
Diopsys® Sticker Eye Patch – PURPLE BUTTERFLY
(6013-0002-01)
250/Roll
$40.00
 
Total**
 
**Sales Tax and Shipping/Handling Charges will be billed accordingly. Please expect 4-5 days for delivery.
Method of Payment (please check one box):
 Please bill me. Check made payable to Diopsys. Inc.(due upon receipt of invoice) I will phone in to pay by credit card. (973-244-0622)
PO Number:
Additional Notes:
 :Typing your name above in the name field is the same as signing your signature and is legally binding. Please check the box that you have read this statement.