Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | West Florida Division | ||
| Site/Hospital | HCA Center for Clinical Advancement | ||
| Billing | Delivery | ||
| Name | Charles.Moore@hcahealthcare.com | Name | Matt Moore |
| George.Greene1@healthtrustpg.com | Charles.Moore@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 560 S. Lakewood Dr. |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | Ste 210 |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Brandon |
| State | TN | State | FL |
| ZIP | 37203 | ZIP | 33511 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 10 | $94.50 |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 10 | $15.80 |
| A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 5 | $73.25 |
| C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 2 | $176.40 |
| Sub-Total | $359.95 | ||