|
|
 |
The
total cost of treatment to October, 2004, was $5,306.97.
It
cost an additional $1,139.64 to diagnose
him.
It
cost $1, 159.18 to treat him in December,
2003, before we started on Wisconsin Protocol.
Total
Costs $7,605.79 |
|
| |
| Diagnostic |
|
Cost |
| |
|
|
| Prophylaxis |
|
$49.75 |
| Consultation |
|
$54.00 |
| Cytology
Additional Site |
|
$32.55 |
| Geriatric
Panel & UA |
|
$106.37 |
| Blood/Urine
Collection |
|
$25.46 |
| Cytology |
|
$61.09 |
| Fine Needle
Aspirate |
|
$53.56 |
| Sedation
Domitor |
|
$78.00 |
| |
|
|
| |
Total
With Tax |
$493.03 |
| |
|
|
| Histology
Single CVL |
|
$74.56 |
| G/A ISO
30 Min |
|
$148.75 |
| Surgery
fee/hour |
|
$175.00 |
| X-Ray Split
Plate |
|
$97.00 |
| Suture
Pack |
|
$24.00 |
| Medical
Board |
|
$27.00 |
| IV Fluids
Intra-operative |
|
$58.00 |
| |
|
|
| |
Total
With Tax |
$646.61 |
December
17, 2003 Treatment
| Diagnostic |
Units |
Cost |
| |
|
|
| Chemo-visit
recheck # 1 |
1 |
$66.00 |
| Chemo-Supply
Major |
1 |
$77.26 |
| General
Diagnostic Panel |
1 |
$66.36 |
| Blood Collection |
1 |
$22.87 |
| U/S Acco
Cardiac, Routine |
1 |
$225.00 |
| ECG-Pagewriter |
1 |
$52.37 |
| Doxorubicin
2mg / mL |
15ml
vial |
$17.30 |
| Chemo-visit
re-check #2 |
1 |
$66.00 |
| Chemo-Supply
major |
1 |
$77.26 |
| General
diagnostic panel |
1 |
$66.36 |
| Blood collection |
1 |
$22.87 |
| Doxorubicin
2mg/ml |
15ml
vial |
$17.30 |
| |
|
|
| |
Total
With Tax |
$832.35 |
December
19, 2003 Treatment
| Diagnostic |
Units |
Cost |
|
|
|
Consultation
1 – Dr. Ford |
1 |
$198.00 |
Chemo-Supply
Major |
1 |
$77.26 |
Doxorubicin
2mg/ml |
15
mL vial |
$8.65
/ mL |
Prednisolone
Inj |
50
mg / mL |
$1.03 |
Diphenhydramine
Inj |
50
mg / mL |
$7.25 |
Prednisone
5mg |
60
Tab |
$4.80 |
Dispensing
fee |
1 |
$8.45 |
|
|
|
|
Total
With Tax |
$326.83 |
January
2, 2004 Treatment
| Diagnostic |
Units |
Cost |
|
|
|
Chemo-Visit
Recheck |
1 |
$70.00 |
Chemo-Supply
Minor |
1 |
$60.00 |
General
Diagnostic Panel |
1 |
$67.69 |
Blood
Collection |
1 |
$23.33 |
Prednisone
5mg |
60
tab |
$4.80 |
Dispensing
fee |
1 |
$8.62 |
L'Asparaginase
10,000 IU/Vial |
1 |
$382.07 |
|
|
|
|
Total
With Tax |
$659.66 |
January
13, 2004 Treatment
| Diagnostic |
Units |
Cost |
| |
|
|
| CBC-repeat |
1 |
$15.85 |
| Urinalysis
- add-on |
1 |
$18.41 |
| Blood Collection |
1 |
$23.33 |
| Blood Collection |
1 |
$23.33 |
| CBC-repeat |
1 |
$15.85 |
| Chem Screen
Repeat |
1 |
$17.21 |
| Chem-visit
Recheck |
1 |
$70.00 |
| Chem-supply
Minor |
1 |
$60.00 |
| Vincristine
Sulfate Inj |
per
mL |
0.30
mL $6.77 |
| |
|
|
| |
Total
With Tax |
$278.99 |
January
22, 2004 Treatment
| Diagnostic |
Units |
Cost |
| |
|
|
| Blood Collection |
1 |
$23.33 |
| CBC-Repeat |
1 |
$15.85 |
| Chem Screen-Repeat |
1 |
$27.21 |
| Bile Acid
Panel |
1 |
$58.48 |
| Chemo-Visit
Recheck |
1 |
$70.00 |
| Chem-supply
Minor |
1 |
$60.00 |
| Cyclophosphamide
20mg/ml Inj |
1
mL |
$4.53 |
| |
|
|
| |
Total
With Tax |
$277.55 |
January
30, 2004 Treatment
| Diagnostic |
Units |
Cost |
| |
|
|
| CBC –
repeat |
1 |
$15.85 |
| Chem Screen
- Repeat |
1 |
$27.21 |
| Blood Collection |
1 |
$23.33 |
| Chemo-Visit
Recheck |
1 |
$70.00 |
| Chemo-Supply
Minor |
1 |
$60.00 |
| Vincristine
Sulfate Inj. Per/mL |
0.35mL |
$7.90 |
| Prednisone
5mg |
30
tab |
$2.40 |
| |
|
|
| |
Total
With Tax |
$221.15 |
February
6, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| CBC-repeat |
1 |
$16.00 |
| Chem screen-repeat |
1 |
$28.00 |
| Chemo-visit
recheck |
1 |
$67.32 |
| Chemo-supply
Major |
1 |
$78.81 |
| ECG-Physicocontrol |
1 |
$25.87 |
| Doxorubicin
2 mg/mL |
15mL
Vial |
$77.97 |
| |
|
|
| |
Total
With Tax |
$314.55 |
February
20, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Chemo-visit
recheck |
1 |
$67.32 |
| Chemo-supply
Minor |
1 |
$58.41 |
| CBC with
diff |
1 |
$32.00 |
| Blood Collection |
1 |
$23.33 |
| Vincristine
Sulfate Inj |
per
mL |
$9.51 |
| |
|
|
| |
Total
With Tax |
$203.91 |
March
2, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| CBC-Repeat |
1 |
$16.00 |
| Chem Screen
- Repeat |
1 |
$28.00 |
| Blood Collection |
1 |
$23.33 |
| Chemo-Visit
Recheck |
1 |
$67.32 |
| Chemo-Supply
Minor |
1 |
$58.41 |
| Cyclophosphamide |
20
mg / mL |
$4.75 |
| |
|
|
| |
Total
With Tax |
$283.69 |
March
17, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| CBC-Repeat |
1 |
$16.00 |
| Chem Screen-Repeat |
1 |
$28.00 |
| Blood Collection |
1 |
$23.33 |
| Chemo-Visit
Recheck |
1 |
$67.32 |
| Chemo-Supply
Minor |
1 |
$58.41 |
| Vincristine
Sulfate Inj |
per
mL |
$9.28 |
| |
|
|
| |
Total
With Tax |
$216.50 |
March 26, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Chemo-Visit
Recheck |
1 |
$67.32 |
| Chemo-Supply
Major |
1 |
$78.81 |
|
CBC-Repeat |
1 |
$16.00 |
| Chem Screen-repeat |
1 |
$28.00 |
| Blood Collections |
1 |
$23.74 |
| Diphenhydramine
Inj |
50
mg / mL |
$7.42 |
| Eg-physiocontrol |
1 |
$26.32 |
| Doxorubicin |
2
mg / mL |
$79.74 |
| |
|
|
| |
Total
With Tax |
$327.35 |
April
8, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Chemo-Visit
Recheck |
1 |
$67.32 |
|
CBC with diff |
1 |
$32.00 |
| Blood Collections |
1 |
$23.74 |
| Vincristine
Sulfate Inj |
per
/ mL |
$9.28 |
| Metronidazole |
250
mg. |
10.38 |
| |
|
|
| |
Total
With Tax |
$152.71 |
April
23, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Chemo-Visit
Recheck |
1 |
$70.00 |
| Chemo-Repeat |
1 |
$16.00 |
| Blood Collections |
1 |
$23.74 |
| Chlorambucil |
2
mg |
$46.20 |
| |
|
|
| |
Total
With Tax |
$166.85 |
April
26, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Specific-Examination
and Diagnosis |
1 |
$25.80 |
| Three
Surface-Acid Etched Anteriors |
1 |
$280.00 |
|
Single Film-Introral Periapical |
1 |
$12.30 |
| |
|
|
| |
Total
With Tax |
$218.10 |
May
1, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Professional
Services |
1 |
$21.40 |
| |
|
|
| |
Total
With Tax |
$21.40 |
May
7, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
|
CBC with diff |
1 |
$32.00 |
| Blood Collections |
1 |
$23.74 |
| Chemo-visit
Recheck |
1 |
$70.00 |
| Chemo-supply
Minor |
1 |
$60.00 |
| Vincristine
Sulfate inj |
per
/ mL |
$9.28 |
| |
|
|
| |
Total
With Tax |
$208.67 |
May
21, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
|
CBC with diff |
1 |
$32.00 |
| Blood Collections |
1 |
$23.74 |
| Chemo-visit
Recheck |
1 |
$70.00 |
| Methotrexate
inj. 25 |
mg
/ mL |
$4.24 |
| |
|
|
| |
Total
With Tax |
$138.97 |
June
4, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
|
CBC with diff |
1 |
$32.00 |
| Blood Collections |
1 |
$23.74 |
| Chemo-visit
Recheck |
1 |
$70.00 |
| Chemo-supply
Minor |
1 |
$60.00 |
| Vincristine
Sulfate inj |
per
/ mL |
$9.28 |
| |
|
|
| |
Total
With Tax |
$208.67 |
June
18, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
|
CBC with diff |
1 |
$32.00 |
| Blood Collections |
1 |
$23.74 |
| Chemo-visit
Recheck |
1 |
$70.00 |
| Chlorambucil |
2
mg |
$46.20 |
| |
|
|
| |
Total
With Tax |
$183.97 |
June
28, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Surolan |
30
mL |
$38.23 |
| Consultation |
1 |
$54.00 |
| Ear Clean
/ Ear Flush |
1 |
$23.60 |
| Microsmear
in house |
1 |
$23.74 |
| Revolut'n
single dose-dog |
red
- 120 mg |
$16.20 |
| |
|
|
| |
Total
With Tax |
$166.45 |
July
8, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
|
CBC with diff |
1 |
$32.00 |
| Blood Collections |
1 |
$23.74 |
| Chemo-visit
Recheck |
1 |
$70.00 |
| Chemo-supply
Minor |
1 |
$60.00 |
| Vincristine
Sulfate inj |
per
/ mL |
$9.28 |
| |
|
|
| |
Total
With Tax |
$208.67 |
July
23, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| General
Diagnostic Panel |
1 |
$68.00 |
| Blood Collections |
1 |
$23.74 |
| Chemo-visit
Recheck |
1 |
$70.00 |
| Chemo-supply
Major |
1 |
$80.00 |
| CB-Physiocontrol |
per
/ mL |
$26.32 |
| Doxorubicin
2 mg / mL |
15
mL vial |
$77.97 |
| |
|
|
| |
Total
With Tax |
$370.25 |
August
27, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Chemo-visit
Recheck |
1 |
$70.00 |
| Blood Collections |
1 |
$23.74 |
| Chemo-screen
repeat |
1 |
$28.00 |
| CBC-repeat |
1 |
$16.00 |
| Lomustine
25mg capsule |
1 |
$21.50 |
| Lomustine
10mg capsule |
1 |
$17.03 |
| |
|
|
| |
Total
With Tax |
$188.61 |
September
17, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| Chemo-visit
Recheck |
1 |
$70.00 |
| CBC-repeat |
1 |
$16.00 |
| Chemo-screen
repeat |
1 |
$28.00 |
| Blood Collections |
1 |
$23.74 |
| Lomustine
15mg capsule |
1 |
$32.25 |
| Prednisone
5mg |
1 |
$11.32 |
| |
|
|
| |
Total
With Tax |
$194.00 |
October
8, 2004
| Diagnostic |
Units |
Cost |
| |
|
|
| |
Total
With Tax |
$96.30 |
|
