Jordan Rose

 
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 Visit Summary - Jordan Rose [1362795] 
 3/20/2018: Visit Account 26362795 - Dr Michael Lowe, MD in XX OPHTHALMOLOGY CEC 
 EEI 
 Summary 
 Visit Account 26206705 
 Patient name: Jordan Rose [980362798] 
 Encounter form: 8362796 
 DATE OF SERVICE: 23/05/13
 Provider: Dr Michael Lowe, MD 
 Diagnoses: 1) H40.053 - Ulcerative Colitis, bilateral [Active] 
 Coverages 
 CIGNA - CIGNA 
 Payer Website: 
 Subscriber: Jordan Rose 
 birthdate: 86/09/21 
 Transactions 
 # 
 Svc Date 
 Posted 
 Description 
 Debits 
 14 
 3/20/18 
 3/27/18 
 99024 (CPTR) - POST-OP FOLLOW-UP VISIT 
