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Medical
Dental (cont'd)
Dr. Hill (Wayne) 2488.53 Forward
Diagnosis exam 2/3/2 10.00
4 x - rays 16.00
Teeth cleaning 30.00
Filling 75.00 191.
Pulp cap 10.00
Extraction 50.00
Exam + cleaning 65.00
Ins. reinb 63.00 E082
Exen + Cleaning 2.00 Jun 4/13/83
(Insurance paid $63)
77.50(crossed out)
Capping tooth 120.00 sep
Covered by ins 42.50 sep
Exam 15, cleaning 30, x-rays 20 on 12/7 65.00
Insurance paid directly 60.00
1/28 Pay balance 5.00 Mar
Browning two front composites $150
Insurance paid 72.25
5/4 Pay to first pacific 77.75 Jun
Sux composite fillings 290
Insurance paid 216.75 Jul(crossed out)
Pay to Wayne Hill 73.25 Jul
3/11 Dr Vandensteen 15.00 Apr

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