Joanna Dieron Medical Expenses

I. Preliminary Lab Test Receipt No. Amount

Chest Xray 300.00
EKG 450.00
See Humana Receipt
CBC 250.00
Liver Ultrasound 906.00
Total 1,906.00

II. First Chemotheraphy Receipt No. Amount

Neuquinon 10mg tablet No. 38459 1,056.00
Alanine aminotranferase (SGPT) 287.00
No. 351453
CBC & Platelate 168.00
FAC 5,769.00
No. 1265
Doctors FEE 1,500.00
2D Echo Readers Fee No. 2433 850.00
2d echo w/Dopplers No. 351650 1,700.00
NKTI Her2Neu Lab test 11,500.00
No. 2712667
Doctors FEE 1,400.00
Follow Up CBC No. 352920 168.00
Total 24,398.00

III. Second Chemotheraphy Receipt No. Amount

Follow up Chest XRAY No. 353936 330.00
FAC 5,819.00
No.1315
Doctors FEE 1,500.00
Butterfly Sutures
Syringe 05CC
No. 354970 815.05
Syringe 20CC
Needle G. 19
CBC & Platelets No. 724383 285.00
Mercury Drug Medicines for Nausea No. 760452 112.00
Follow up CBC No. 725317 285.00
Macroleuco WBC Blood shot No. 1334 4,500.00
Mercury Drug Medicines Vitamins No. 369837 1,146.20
Total 14,792.25

IV. Third Chemotheraphy Receipt No. Amount

Butterfly Sutures
Syringe 05CC
No. 339232 607.25
Needle G. 19
CBC & Platelets
FAC 5,819.00
No. 1451
Doctors Fee 1,500.00
Neuquinon 10mg tablet No. 282905 1,473.50
Mercury Drug Medicines for Nausea No. 782918 112.50
Follow up CBC No. 729088 315.00
Ciproxl Antibiotics 500mg No.180854 518.00
Total 10,345.25
 TOTAL EXPENSES 49,535.50
Note : The Following 5 cycles of Chemotheraphy & Radiation will be charge to US Insurance
Rolando Dieron 20,000.00
Tito Frank & Fe Tieck 27,000.00
TOTAL MONEY 47,000.00
o US Insurance
Thru Remittance
Thru Western Union