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  • Itemized Expenses & Illiness Details

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    Gyan
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    I have recently contacted you about XXXXXXXXX. i have not yet heard back but wanted to follow up again, I know just how busy our inboxes get. Have you given any additional thought to the proposal? I’d be happy to do a quick review of it on the phone and answer any pending questions.

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    I have recently contacted you about XXXXXXXXX. i have not yet heard back but wanted to follow up again, I know just how busy our inboxes get. Have you given any additional thought to the proposal? I’d be happy to do a quick review of it on the phone and answer any pending questions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    13 views1 page

    Itemized Expenses & Illiness Details

    Uploaded by

    Gyan
    I have recently contacted you about XXXXXXXXX. i have not yet heard back but wanted to follow up again, I know just how busy our inboxes get. Have you given any additional thought to the proposal? I’d be happy to do a quick review of it on the phone and answer any pending questions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Claimant's Name

    Nirmladevi Upadhyay
    Nirmladevi Upadhyay
    Nirmladevi Upadhyay
    Nirmladevi Upadhyay
    Nirmladevi Upadhyay
    Nirmladevi Upadhyay
    Nirmladevi Upadhyay
    Grand Total

    Date
    6/8/2016
    6/8/2016
    6/8/2016
    6/16/2016
    6/16/2016
    6/17/2016
    6/17/2016

    Charges
    $ 89.00
    $ 11.99
    $ 16.14
    $ 532.00
    $ 119.00
    $ 29.56
    $ 127.00
    $ 924.69

    Illness details
    Diagnosed Shingles rash with pain
    Medication for Shingles
    Medication for Pain
    Pneumonia diagnosed
    Medication for Pneumonia
    Medication for Cough
    Follow up visit for Pneumonia

    Notes
    doctors visit (CVS)
    prescription
    prescription
    care now (urgent care)
    prescription
    prescription
    care now (urgent care)

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