KRUGER STEENKAMP EN KRUGER BIOKINETIESE

STATEMENT / STAAT

PHYSICAL ADDRESS
SPORTS CENTRE - LC DE VILLIERS
SOUTH STREET - HATFIELD PTA
POSTAL ADDRESS
P.O. BOX 13797
TEL: 0124206033
HATFIELD PTA 0028
FAX:0124206099
VAT:NOT REGISTERED

Date:
22/01/2013
Member: MRS DOROTHY MARTHA M
Med Aid: GEMS
Mem No: 000761434
ID/DOB: 5807290755084
Diag.:

MRS DOROTHY MARTHA M LEPHOKO

303 LEDGER AVENUE
DANVILLE
GAUTENG
0183

DATE

PATIENT

17/09/2012 KAGISO LEPHOKO 18/04/1990

Practitioner:
Prac. No:
HPCSA No:

Acc:
8066
Tel (H):
Tel (W):
Cell:
0828696144
Page: 1
Pr No: 0282251

MNR FRANCOIS C. DU TOIT

0282251
BK0018619

CODE

DESCRIPTION

ST

91913

ERGOLOGICAL TESTING EVALUALTION OF BODYS

QTY
1.00

CLAIM
140.00

DISC
0.00

M PORT
0.00

P PORT
140.00

BALANCE
140.00

1.00

85.00

0.00

0.00

85.00

225.00

1.00

145.00

0.00

0.00

145.00

370.00

1.00

80.00

0.00

0.00

80.00

450.00

1.00

80.00

0.00

0.00

80.00

530.00

1.00

80.00

0.00

0.00

80.00

610.00

610.00

0.00

0.00

610.00

610.00

DIAG:Z50.1
17/09/2012 KAGISO LEPHOKO 18/04/1990

91915

POSTURAL ANALYSIS AND/ORANALYSIS OF ACTI

DIAG:Z50.1

17/09/2012 KAGISO LEPHOKO 18/04/1990

91917

PHYSICAL WORK CAPACITY/MUSCULOSKELETAL

DIAG:Z50.1

19/09/2012 KAGISO LEPHOKO 18/04/1990

91923

PROPRIOCEPTION BALANCE AND MOTOR CO

DIAG:Z50.1

19/09/2012 KAGISO LEPHOKO 18/04/1990

91928

A REHABILITIVE EXERCISE PRESCRITION

DIAG:Z50.1

19/09/2012 KAGISO LEPHOKO 18/04/1990

91929

CALLISTHENICS EXERCISES
DIAG:Z50.1

ABSA ACC: 4069976452

NAME: KRUGER STEENKAMP & KRUGER BRANCH: 632005
CURRENT

KRUGER STEENKAMP & KRUGER

PHYSICAL ADDRESS
SPORTS CENTRE - LC DE VILLIERS
SOUTH STREET - HATFIELD PTA
POSTAL ADDRESS
P.O. BOX 13797
HATFIELD PTA 0028

MED AID
PATIENT
TOTAL

0.00
0.00
0.00

30 DAYS
0.00
0.00
0.00

60 DAYS
0.00
0.00
0.00

MRS DOROTHY MARTHA M LEPHOKO

303 LEDGER AVENUE
DANVILLE
GAUTENG
0183

* SUBMITTED TO MEDICAL AID ELECTRONICALLY

REF: 8066
90 DAYS
0.00
0.00
0.00
DATE:
ACCOUNT:
MED AID:
PATIENT:
CREDITS:
TOTAL:

120 DAYS
0.00
610.00
610.00

TOTAL
0.00
610.00
610.00
22/01/2013
8066
0.00
610.00
0.00
610.00