Patient
Marlene Thompson
2418 Coconut Drive
Fort Myers, FL 33907
DOB: 04/12/1957
Service date
Thursday, May 15, 2026
10:00 AM – 11:30 AM
Provider: Dr. Brian Hutcheson, DC
| CPT |
Service rendered |
Qty |
Unit |
Total |
| 99203 |
New patient office visit · 60 min
Initial evaluation, structural exam, history
|
1 |
$285.00 |
$285.00 |
| 98941 |
Chiropractic manipulation · spinal regions (3-4)
Cervical, thoracic, lumbar
|
1 |
$95.00 |
$95.00 |
| 97140 |
Manual therapy techniques · 15 min
Soft tissue mobilization
|
1 |
$65.00 |
$65.00 |
| 97014 |
Electrical stimulation · unattended
Adjunct therapy for lumbar musculature
|
1 |
$35.00 |
$35.00 |
Subtotal$480.00
Adjustment— $0.00
Paid (Visa ending 4421)— $480.00
Balance due$0.00
Notes
Thank you for your visit. A PostureVision® scan was performed as part of today's structural assessment. Your alignment, curvature, stability, and Poise scores are saved in your patient file and available to share with other providers on request. Recommended follow-up: 2 weeks.
Provider signature
Brian Hutcheson, DC
Brian Hutcheson, DC
Doctor of Chiropractic · License #CH00012345
Signed electronically on May 18, 2026
Office use
Initials · date · notes