35 Weymouth Street
London W1G 8BJ
T: +44(0)20 7034 8551
F: +44(0)20 7034 8553
E: info@hcahealthcare.co.uk
W: www.theharleystreetclinic.com
STATEMENT OF ACCOUNT FOR Vladislav Kitaiskii
DOB: 24/09/2004
As of: 26/07/2011
Account Admission Treatment Consultant Payments
Number Date Cost fees Made Procedure Description
H504655 25/07/2011 £ 2,055.71 CT Scan and Blood Count
H503390 15/07/2011 £ 16,559.18 Blood Transfusion (9 Night Stay)
H503112 14/07/2011 £ 30.00 Injection
H502832 13/07/2011 £ 130.00 Blood Count
H502232 10/07/2011 £ 3,857.00 £ 10,000.00 Chemo (2 Night Stay)
H502226 09/07/2011 £ 778.00 Chemo
H502031 08/07/2011 £ 1,557.97 Chemo
H501634 07/07/2011 £ 778.00 Chemo
H501437 06/07/2011 £ 1,701.71 £ 7,000.00 Chemo
H501367 05/07/2011 £ 130.00 Blood Count
H501081 04/07/2011 £ 246.00 Blood Count
£ 2,580.00 Dr Stergios Zacharoulis Fee - 09-26/06/2011
H499737 25/06/2011 £ 11,369.00 Chemo (7 Night Stay)
H499621 24/06/2011 £ 1,355.00 Blood Count (daycase)
£ 250.00 Dr Nick Plowman Fee
H497760 14/06/2011 £ 12,607.76 Chemo (8 Night Stay)
£ 440.00 Dr K Rajput fee
H496298 13/06/2011 £ 5,031.00 Surgery
H497275 11/06/2011 £ 110.00 Bone Marrow Consumables
H497132 10/06/2011 £ 700.50 Renal Ultrasound
H496558 08/06/2011 £ 593.42 £ 593.42 Ultrasound and Pharmacy
£ 485.00 Dr Papas Fee
H496151 06/06/2011 £ 3,470.00 £ 5,789.50 CT Scan and Echo (1 Night Stay)
Totals £ 63,060.25 £ 3,755.00 £ 23,382.92
Amount Outstanding: £ 43,432.33
Kind Regards
Iesha Williams
Self Pay Co-Ordinator
THEHARLEYSTREETCLINIC
35 Weymouth Street
London W1G 8BJ
T 020 7034 8551 (Direct) 68551 (Internal)
F 020 7034 8553
E iesha.williams@hcahealthcare.co.uk
W www.theharleystreetclinic.com