Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | North Florida Division | ||
| Site/Hospital | Ocala Regional Med Ctr | ||
| Billing | Delivery | ||
| Name | dan.fran@hcahealthcare.com | Name | Laura Mckinney |
| George.Greene1@healthtrustpg.com | Laura.McKinney@HCAhealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 4830 SE 24th Street |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Ocala |
| State | TN | State | FL |
| ZIP | 37203 | ZIP | 34471 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 5 | $49.60 |
| C99007 | Brayden Adult Lung Kit Version A04 (Pack of 24) | 1 | $49.61 |
| C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 1 | $92.61 |
| $0.00 | |||
| Sub-Total | $191.82 | ||