Thursday, February 02, 2012

GW Psychiatric Treatment -- Initial Assessment Bill

 DEPARTMENT OF PSYCHIATRY
THE GEORGE WASHINGTON UNIVERSITY MEDICAL FACULTY ASSOCIATES
2150 Pennsylvania Avenue, N.W., Washington, DC  20037  (202 994-4072

Physician Name: Napoleon Cuenco

Account No. 3543061

Patient Name:  Freedman, Gary

Dates of Visits as Follows:  September 1, 1992

(x) Initial Assessment Interview O/P

Total Charges $85.00

Provider's Signature: /s/

DSM-III Code: 799.90

Pd. $85.00

[Inapplicable portions of form omitted.]

___________________________

Physician Name: N. Cuenco

Account No. 3543061

Patient Name:  Freedman, Gary

Dates of Visits as Follows:  September 8, 1992

(x) Initial Assessment Interview O/P

Total Charges $20.00

Provider's Signature: /s/

DSM-III Code: 296.70

[Inapplicable portions of form omitted.]

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