Jody Williams

  
 Recv'd Date: 20221028 
 DCN: 2022541GJ003545 
 Dr Andrew Anderson MD 
 Physical Medicine and Rehabilitation 
 04-06-2020 
 RehabOne 
 RehabOne Programs / KOREAL SECURING 
 PRIMARY TREATING PHYSICIAN'S PROGRESS REPORT (PR-2) 
 Primary Treating Physician: Dr Andrew Anderson MD 
 PATIENT NAME: Jody Williams 
 DATE OF EXAMINATION: 06-29-2019 
 Claim #:038494037909-WC-54 
 Insurance: Gallagher Bassett (Corona) 
 INJURY DATE: 09-04-2016
 Description of case: 1.PTP-LowBack 
 BILLING ATTESTATION: 
 Ms. Araceli Corona DOB was verified prior to disclosing any PHI. 
 CASE SUMMARY: 
 Identification: Ms. Corona is a 80 year -old. 
 Job title at time of injury: account manager 
 Current work/Last date of work: working 
 354 Corona. Araceli : Oct 11. 2022 
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