Go Back

HCA Order Form
Division Far West Division
Site/Hospital Sunrise
Billing Delivery
Name Elizabeth.Cabada@hcahealthcare.com Name Joann Nardoni
Email George.Greene1@healthtrustpg.com Email Joann.nardoni@hcahealthcare.com
Address Line 1 Clinical Education Financial Reporting Address Line 1 3186 S Maryland Pkwy
Address Line 2 Clinical Education Financial Reporting Address Line 2
Address Line 3 Suite 1100 Address Line 3
City Nashville City Las Vegas
State TN State NV
ZIP 37203 ZIP 89109
Items to Order
Code Description Quantity Total ($)
A99003 Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug 2 $30.76
C99008 Brayden Premium Urethane Adult Lung Kit (Pack of 6) $0.00
C17001 Brayden Baby/Infant Replacement Lung (single) 6 $59.52
S13107 Brayden Adult Airway Valve Assembly 1 $3.75
S17011 Brayden Baby/Infant Artificial Lung Air Guide 1 $1.66
S17013 Brayden Baby/Infant Replacement Airway Tube (single) 2 $6.06
  Sub-Total $101.75