rphillips613
Patient; SMITH, Delores. Doctor: Brutus, Part B
Requesting for refills of the following:
iteam #: A64631 PROMOTE W FIBER 8oz CANS CTGRY 1. 150. CAN. 1185 Part B Ticket no. C02748265
And;
IRTRP IRRIG. TRAY PISTON, 30. EACH Part B Ticket no. C02748265;
And lately;
K773662 FEEDING BAG w/ Flush bag -Epump 30. EACH Part B Ticket no. C02748265..... That was made under Master Shipment #; C02748265-01 Dates of
Service: 09//08/2017 - 10/07/2017!!!
Requesting for refills of the following:
iteam #: A64631 PROMOTE W FIBER 8oz CANS CTGRY 1. 150. CAN. 1185 Part B Ticket no. C02748265
And;
IRTRP IRRIG. TRAY PISTON, 30. EACH Part B Ticket no. C02748265;
And lately;
K773662 FEEDING BAG w/ Flush bag -Epump 30. EACH Part B Ticket no. C02748265..... That was made under Master Shipment #; C02748265-01 Dates of
Service: 09//08/2017 - 10/07/2017!!!
Hometown: Brooklyn , New York Kings
Occupation: Health Proxy for Mrs. Delores Smith
Interests: Along with the future above-mentioned items: Mrs. Smith also need the Following request items:
1. 30 days supply of " BED LINING " As well as;
2. " ADALT XXL DISPOSABLE UNDERWEAR " supply for 30 days.... Thanks for your time and Services!!
Sincerely yours,
Russell Phillips,
Son of Applicant-Patient,
Health Power-of-Attorney, Pro-se'
1. 30 days supply of " BED LINING " As well as;
2. " ADALT XXL DISPOSABLE UNDERWEAR " supply for 30 days.... Thanks for your time and Services!!
Sincerely yours,
Russell Phillips,
Son of Applicant-Patient,
Health Power-of-Attorney, Pro-se'
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