Invoices
INVOICE
MP-202604-0009
Baylor University Medical Center → Southwest Transplant Alliance
submitted
FINANCIALS
Amount$35,000.00
Platform Fee-$437.50
Net Payout$34,562.50
CMS CLASSIFICATION
Cost Center
Organ AcquisitionWorksheet / Line
A / 00400
Description
Donor Hospital — ICU, OR, labs at cost-to-charge ratio
TIMELINE
Created4/6/2026
Submitted4/5/2026
Case IDDC-2026-0412
LINE ITEMS
| DESCRIPTION | QTY | UNIT PRICE | AMOUNT |
|---|---|---|---|
| ICU bed-days (3 days at cost-to-charge ratio) | 3 | $8,500.00 | $25,500.00 |
| OR time (recovery procedure, 4 hrs) | 4 | $1,500.00 | $6,000.00 |
| Lab panel (CBC, BMP, coag, UA) | 1 | $3,500.00 | $3,500.00 |