c E . D. 4 8 F E 5 MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA EDW Programme Section Medicare Patient History Report - IN CONFIDENCE Based on date of service for the eriod 01JUL2005 to 13APR2010 Rendering· Provider Location, Name and Address HARRIS ,DR CATHERINE SUTHERLAND ,DR MARY-ANNE ST GEORGE ,DR BERNARD DOULL ,DR FRANCES MIGLANI ,DR RAMAN CHEN ,DR KING NGUYEN ,DR THANH PHONG KANG ,DR SHINYOUNG HEALY ,DR MATTHEW PAGE: 1 :' . . ·. ,, · ' "· - .. TAL.004.001.0402 '.
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MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA … · 2019. 10. 18. · MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA EDW Programme Section Medicare Patient History Report
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c E
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F
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5
MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA
EDW Programme Section Medicare Patient History Report - IN CONFIDENCE
Based on date of service for the eriod 01JUL2005 to 13APR2010
Rendering· Provider Location, Name and Address
HARRIS ,DR CATHERINE
SUTHERLAND ,DR MARY-ANNE
ST GEORGE ,DR BERNARD
DOULL ,DR FRANCES
MIGLANI ,DR RAMAN
CHEN ,DR KING
NGUYEN ,DR THANH PHONG
KANG ,DR SHINYOUNG
HEALY ,DR MATTHEW
PAGE: 1
:' . .
·.,,· ' "·- ..
TAL.004.001.0402
'.
.•
MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA
EDW Programme Section Medicare Patient History Report - IN CONFIDENCE
Based on date of service for the eriod 01JUL2005 to 13APR2010 Name:
Date of bi
Ordering Provider Location, Name and Address
2 RYAN ,OR DAMIAN
H SUTHERLAND ,DR MARY-ANNE
PAGE:2
TAL.004.001.0403
/
MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA
EDW Programme Section Medicare Patient History Report - IN CONFIDENCE
Based on date of service for the eriod 01JUL2005 to 13APR2010
00023
00036
00296
02713
55076
55800
59300
66512
66596
66599
66608
66716
73053
73928
73938
Name Date of birt
Item Number and Description
CONSULTATION AT CONSULTING ROOMS - LEVEL 'B' (See F9)
CONSULTATION AT CONSUL TING ROOMS - LEVEL 'C' (See F9)
Consultant Psychiatrist, Initial consultation on a new patient.Consult
Attendance for GP Mental Health Treatment.
UIS Both breasts
U/S Hand or wrist, 1 or both sides
Mammogram
General chemistry x 5 or more.
Iron studies
Serum 812 or folate
Vitamin D
TSH
Pap smear - screening
Initiation of a patient episode by collection of a specimen for 1 or m
Initiation of a patient episode
PAGE: 3
TAL.004.001.0404
MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA
EDW Programme Section Medicare Patient History Report - IN CONFIDENCE
Based on date of service for the eriod 01 JUL2005 to 13APR2010 Name:
Date of bi
Bill type & description
PAGE: 4
TAL.004.001.0405
·~
r
12JAN2007 00023 $32.10 $32.10
26MAY2007 02713 $66.00 $66.00
04JUL2007 000;36 $60.95 $60.95
22NOV2007 02713 $67.45 $67.45
03MAR2008 00023 $32.80 $32.80
06AUG2008 00023 $32.80 $32.80
06AUG2008 66512 $15.15 $15.15
06AUG2008 66596 $28.15 $28.15
06AUG2008 66716 $21.65 $21 .65
06AUG2008 73938 $8.35 $8.35
MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA
EDW Programme Section Medicare Patient History Report - IN CONFIDENCE
.. • • ... • ... • • I I I • Based on date of servic :13APR2010 Name