Lisa Peterson

 LON 
 ETH 
 INTERVENTIONAL PAIN CENTERS 
 Estimate 
 Name: Johnson, Karen 
 Date: 14 May 2016
 DOB: 29 Sep 1997 
 Order date 
 Activity 
 Amount 
 21 May 2020
 Professional Medical Services/Physician 
 $4834 
 Fees: 62334, Cervical ESI 
 01 Sep 2018 
 Professional Medical Services/Physician Fees: 
 $334 
 77003 Fluoroscopy for Needle Guidance 
 Total = 
 $5134 
 4213 Teuton Street Metairie, LA 70006 Phone 504xxxxx Fax 504xxxx
 www.lonsethpain.com
