Nicholas Green

 LON 
 ETH 
 INTERVENTIONAL PAIN CENTERS 
 Estimate 
 Name: Johnson, Karen 
 Date: 2021-11-02
 DOB: 2004-10-03 
 Order date 
 Activity 
 Amount 
 2024-05-03
 Professional Medical Services/Physician 
 $4826 
 Fees: 62326, Cervical ESI 
 2017-19-08 
 Professional Medical Services/Physician Fees: 
 $326 
 77003 Fluoroscopy for Needle Guidance 
 Total = 
 $5126 
 4213 Teuton Street Metairie, LA 70006 Phone 504xxxxx Fax 504xxxx
 www.lonsethpain.com
