Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Central West Texas Division | ||
| Site/Hospital | Del Sol Medical Ctr | ||
| Billing | Delivery | ||
| Name | James.Marion@stdavids.com | Name | Jasmine Duran |
| George.Greene1@healthtrustpg.com | james.marion@stdavids.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 10555 Vista Del Sol, Building 3 Suite 100, El Paso, TX 79925 |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 10555 Vista del Sol Suite 100 |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | El Paso |
| State | TN | State | TX |
| ZIP | 37203 | ZIP | 79925 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| S16402 | Brayden Pro Adult Body Skin Magnet | 6 | $24.84 |
| A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 6 | $92.28 |
| C99003 | Brayden Adult Airway Filter (Pack of 24) | 1 | $4.46 |
| C99007 | Brayden Adult Lung Kit Version A04 (Pack of 24) | 1 | $49.61 |
| S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 8 | $24.24 |
| C99002 | Brayden Adult Airway Silicone Flap Valve (Pack of 24) | 1 | $7.75 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 10 | $99.20 |
| S13107 | Brayden Adult Airway Valve Assembly | 6 | $22.50 |
| $0.00 | |||
| Sub-Total | $324.88 | ||