Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | San Antonio Division | ||
| Site/Hospital | Methodist Childrens Hospital | ||
| Billing | Delivery | ||
| Name | Abram.Bustamante@MHShealth.com | Name | Abram Bustamante |
| George.Greene1@healthtrustpg.com | abram.bustamante@mhshealth.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 8109 Fredericksburg Rd, 2nd floor CAPE center |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 2nd floor CaPE Center |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | San Antonio |
| State | TN | State | TX |
| ZIP | 37203 | ZIP | 78229 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 6 | $87.90 |
| C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 1 | $92.61 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 6 | $59.52 |
| S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 6 | $18.18 |
| Sub-Total | $258.21 | ||