c E

. D .

4

~ 8

F

E

5

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

Based on date of service for the eriod 01JUL2005 to 13APR2010

Rendering· Provider Location, Name and Address

HARRIS ,DR CATHERINE

SUTHERLAND ,DR MARY-ANNE

ST GEORGE ,DR BERNARD

DOULL ,DR FRANCES

MIGLANI ,DR RAMAN

CHEN ,DR KING

NGUYEN ,DR THANH PHONG

KANG ,DR SHINYOUNG

HEALY ,DR MATTHEW

PAGE: 1

:' . .

·.,,· ' "·- ..

TAL.004.001.0402

'.

.•

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

Based on date of service for the eriod 01JUL2005 to 13APR2010 Name:

Date of bi

Ordering Provider Location, Name and Address

2 RYAN ,OR DAMIAN

H SUTHERLAND ,DR MARY-ANNE

PAGE:2

TAL.004.001.0403

/

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

Based on date of service for the eriod 01JUL2005 to 13APR2010

00023

00036

00296

02713

55076

55800

59300

66512

66596

66599

66608

66716

73053

73928

73938

Name Date of birt

Item Number and Description

CONSULTATION AT CONSULTING ROOMS - LEVEL 'B' (See F9)

CONSULTATION AT CONSUL TING ROOMS - LEVEL 'C' (See F9)

Consultant Psychiatrist, Initial consultation on a new patient.Consult

Attendance for GP Mental Health Treatment.

UIS Both breasts

U/S Hand or wrist, 1 or both sides

Mammogram

General chemistry x 5 or more.

Iron studies

Serum 812 or folate

Vitamin D

TSH

Pap smear - screening

Initiation of a patient episode by collection of a specimen for 1 or m

Initiation of a patient episode

PAGE: 3

TAL.004.001.0404

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

Based on date of service for the eriod 01 JUL2005 to 13APR2010 Name:

Date of bi

Bill type & description

PAGE: 4

TAL.004.001.0405

·~

r

12JAN2007 00023 $32.10 $32.10

26MAY2007 02713 $66.00 $66.00

04JUL2007 000;36 $60.95 $60.95

22NOV2007 02713 $67.45 $67.45

03MAR2008 00023 $32.80 $32.80

06AUG2008 00023 $32.80 $32.80

06AUG2008 66512 $15.15 $15.15

06AUG2008 66596 $28.15 $28.15

06AUG2008 66716 $21.65 $21 .65

06AUG2008 73938 $8.35 $8.35

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

.. • • ... • ... • • I I I • Based on date of servic :13APR2010 Name

Date of b

$32.10 6 19JAN2007 12JAN2007 E

$66.00 6 01JUN2007 26MAY2007 8

$60.95 6 12JUL2007 04JUL2007 E

$67.45 6 08DEC2007 22NOV2007 E

$32.80 6 11 MAR2008 03MAR2008 E

$32.80 6 07 AUG2008 06AUG2008 E

$17.80 6 07AUG2008 07AUG2008 4

$33.10 6 07 AUG2008 07 AUG2008 4

$25.45 6 07AUG2008 07AUG2008 4

$9.80 6 07 AUG2008 07 AUG2008 4

KANG ,DR SHINYOUNG

CHEN ,DR KING

SUTHERLAND ,DR MARY­ANNE

SUTHERLAND ,DR f'.?ARY­ANNE

SUTHERLAND ,DR MARY­ANNE

SUTHERLAND ,DR MARY­ANNE

MIGLANI ,DR RAMAN

MIGLANI ,DA RAMAN

MIGLANI ,DA RAMAN

MIGLANI ,DR RAMAN

18AUG2008 00023 $32.80 $32.80 . $32.80 6 19AUG2008 18AUG2008 E SUTHERLAND ,DR MARY­ANNE

PAGE: 5

E

E

E

E

TAL.004.001.0406

; ,.~ .. · ':; •' .

SUTHERLAND ,DR MARY­ANNE

SUTHERLAND ,DR MARY­ANNE

SUTHERLAND ,DR MARY­ANNE

SUTHERLAND ,DR MARY­ANNE

18AU~2008 66599 $20.45 $20.45

I i 18AUG2008 73938 $8.35 $8.35

• 22SEP2008 00023 $32.80 $32.80

26FEB2009 73053 $16.70 $16.70

26FEB2009 00023 $33.55 $33.55

26FEB2009 66596 $28.15 $28.15

26FEB2009 66599 $20.45 $20.45

26FEB2009 66608 $36.55 $36.55

26FEB2009 73938 $8.35 $8.35

17MAR2009 00023 $33.55 $33.55

26MAR2009 00023 $33.55 $33.55

01APR2009 00023 $33.55 $33.55

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

Based on date of service for the eriod 01JUL2005 to 13APR2010 Name:

Date of bi

$24.05 6 26AUG2008 19AUG2008 4 MIGLANI ,DR RAMAN

$9.80 6 26AUG2008 19AUG2008 4 MIGLANI ,DR RAMAN

$32.80 6 22SEP2008 22SEP2008 E SUTHERLAND ,DR MARY-ANNE

$19.60 6 23APR2009 .25MAR2009 4 HARKNESS ,DR JOHN

$33.55 6 27FEB2009 26FEB2009 E SUTHERLAND ,DR MARY-ANNE

$33.10 6 06MAR2009 06MAR2009 4 MIGLANI ,DR RAMAN

$24.05 6 06MAR2009 06MAR2009 4 MIGLANI ,DR RAMAN

$43.00 6 06MAR2009 06MAR2009 4 MIGLANI ,DR RAMAN

$9.80 6 06MAR2009 06MAR2009 4 MIGLANI ,DR RAMAN

$33.55 6 17MAR2009 17MAR2009 E SUTHERLAND ,DR MARY-ANNE

$33.55 6 26MAR2009 26MAR2009 E SUTHERLAND ,DR MARY-ANNE

$33.55 6 01APR2009 01APR2009 E SUTHERLAND ,DR MARY-ANNE

PAGE:6

TAL.004.001.0407

E SUTHERLAND ,DR MARY-)~ l l ANNE

E SUTHERLAND ,DR MARY-ANNE

E SUTHERLAND ,DA MARY- /)~ ~ ANNE , ~!?· -cc ..

E SUTHERLAND ,DA MARY-ANNE i .. \,/'\

E SUTHERLAND ,DR MARY-;..~ -::. ANNE

E SUTHERLAND ,DR MARY-\i-.z)) ANNE

E SUTHERLAND ,DR MARY-ANNE

08APR2009 00023 $33.55 $33.55

08APR2009 55076 $92.75 $92.75

08APR2009 59300 $71.85 $71.85

15APR2009 00023 $33.55 $33.55

-~ 18MAY2009 00023 $33.55 $33.55

.. 01JUN2009 00023 $33.55 $33.55

10JUN2009 00023 $33.55 $33.55

19FEB2010 55800 $103.65 $103.65

12MAR2010 00296 $209.10 $209.10

30MAA2010 66596 $27.85 $27.85

30MAR2010 66599 $20.20 $20.20

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

Based on date of servic to 13APR2010

$33.55 6 08APR2009 08APR2009 E SUTHERLAND ,DR MARY-ANNE

$109.10 6 14APR2009 14APR2009 D DOULL ,DR FRANCES

$84.50 6 14APR2009 14APR2009 D DOULL ,DR FRANCES

$33.55 6 15APR2009 15APR2009 E SUTHERLAND ,DR MARY-ANNE

$33.55 6 20MAY2009 20MAY2009 F NGUYEN ,DR THANH PHONG

$33.55 6 02JUN2009 01JUN2009 E SUTHERLAND ,DR MARY-ANNE

$33.55 6 10JUN2009 10JUN2009 E SUTHERLAND ,DR MARY-ANNE

$109.10 6 19MAR2010 19MAR2010 5 HEALY ,DR MATIHEW

$246.00 6 30MAR2010 23MAR2010 1 ST GEORGE ,DR BERNARD

$32.75 6 07APR2010 06APR2010 c HARRIS ,DA CATHERINE

$23.75 6 07APR2010 06APR2010 c HARRIS ,DR CATHERINE

PAGE: 7

TAL.004.001.0408

E SUTHERLAND ,DR MARY- ·'

ANNE ._. . ' --E SUTHERLAND ,DR MARY- #,." ,,.. ,~ .. "\,,

ANNE

2 RYAN ,DR DAMIAN . ... ~ .>-' .,..

H SUTHERLAND ,DR MARY-)~~· ':-· ANNE

H SUTHERLAND ,DR MARY- : ~a..~#~ ANNE

H SUTHERLAND ,DR MARY- ,ff.. . .., ANNE

~ -l-

30MAR2010 66716 $21.45 $21.45

30MAR2010 73928 $5.10 $5.10

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

- - - ---- -· · ·· - ...... Based on date of servi 2010 Nam

Date of '

$25.20 6 07APR2010 06APR2010 C HARRIS ,DR CATHERINE H

$6.00 6 07APR2010 06APR2010 C HARRIS ,DR CATHERINE H

PAGE: 8

TAL.004.001.0409

SUTHERLAND ,DR MARY­ANNE

SUTHERLAND ,DR MARY­ANNE

c.. y-...... ,4 ; \ ~ '

MEDICARE REPORT Run Date: 09JUN10 MEDICARE AUSTRALIA

EDW Programme Section Medicare Patient History Report - IN CONFIDENCE

Based on date of service for the eriod 01 JUL2005 to 13APR2010 Name

Date of b

••• END OF REPORT . ..

PAGE: 9

TAL.004.001.0410