Matthew Chung

  
 STATEMENT 
 THIS IS A STATEMENT OF SERVICES RENDERED BY PHYSICIAN(S) 
 WHO ARE MEMBERS OF: 
 PATIENT NAME 
 Seaside Medical 
 Matthew Chung 
 8626 TESORO DRIVE 
 BILL DATE 
 ACCOUNT NO. 
 AMOUNT PAID 
 SUITE 112 
 SAN ANTONIO, TX 782176207 
 Jul 15, 2021 
 15032 
 210-817-6010 
 Seaside Medical 
 1811 E AVENUE K 
 This is a statement for professional services rendered by your 
 physician. You may receive a separate bill from the hospital for 
 APT 1002 
 its services. 
 TEMPLE TX 76501-6292 
 PMT/ADJ/ 
 DATE OF SERVICE 
 DESCRIPTION OF SERVICE 
 CHARGES 
 AMOUNT 
 WITHHELD 
 16 February 2023 
 Claim:27617, Provider: ALEXANDER M ABOKA, MD 
 Feb 01, 2021 
 OFFICE VISIT, NEW PT LEVEL 4 
 $850.00 
 Your Balance Due On These Services 
 $850.00 
 Mar 17, 2021 
 Claim:29679, Provider: ALEXANDER M ABOKA, MD 
 DATE 
 PATIENT NAME 
 ACCOUNT NO. 
 PAY THIS 
 19 May 2017 
 Matthew Chung 
 15032 
 AMOUNT 
 $21,050.00 
 10 November 2023
 1 
 3:34:01 PM
 