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HCA Order Form |
Division | Far West Division | ||
Site/Hospital | Los Robles | ||
Billing | Delivery | ||
Name | Elizabeth.Cabada@hcahealthcare.com | Name | Kerri Steckel |
George.Greene1@healthtrustpg.com | Kerri.Steckel@hcahealthcare.com | ||
Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 215 W Janss Rd |
Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
Address Line 3 | Suite 1100 | Address Line 3 | |
City | Nashville | City | Thousand Oaks |
State | TN | State | CA |
ZIP | 37203 | ZIP | 91360 |
Items to Order | |||
Code | Description | Quantity | Total ($) |
A99002 | Brayden Adult Compression Spring Addon | 1 | $23.84 |
C17001 | Brayden Baby/Infant Replacement Lung (single) | 3 | $29.76 |
S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 3 | $4.98 |
S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 2 | $6.06 |
S17008 | Brayden Baby/Infant Spring | 1 | $15.99 |
Sub-Total | $80.63 |