Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | East Florida Division | ||
| Site/Hospital | JFK Medical Center | ||
| Billing | Delivery | ||
| Name | Colleen.Cannon@HCAhealthcare.com | Name | Maritess Quinto |
| George.Greene1@healthtrustpg.com | Maritess.Quinto@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 5301 S. Congress Ave. |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Atlantis |
| State | TN | State | FL |
| ZIP | 37203 | ZIP | 33462 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 30 | $283.50 |
| C99007 | Brayden Adult Lung Kit Version A04 (Pack of 24) | 3 | $141.75 |
| C99003 | Brayden Adult Airway Filter (Pack of 24) | 1 | $4.25 |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 15 | $23.70 |
| $0.00 | |||
| Sub-Total | $453.20 | ||