Scheduling

TEST CODE: 95044 ICD-10 DX CODE: L30.9 QUANTITY: 50 *Please check insurance coverage prior to testing.

Scheduling:

? Apply patches on a Mon Appt 1: _____________________

? Remove patches on a Wed (with MA) Appt 2: _____________________

? Read on Thurs or Fri (with provider) Appt 3: _____________________

2835 82nd Ave SE, Suite 210 Mercer Island, WA 98040 ph. 206.236.3030

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Board Certified Dermatologist owned and operated. Patient financing available.

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