Jason Scott

  
 Recv'd Date: 20221028 
 DCN: 2022331GJ003335 
 Dr Garrett Perez MD 
 Physical Medicine and Rehabilitation 
 2015/18/03 
 RehabOne 
 RehabOne Programs / KOREAL SECURING 
 PRIMARY TREATING PHYSICIAN'S PROGRESS REPORT (PR-2) 
 Primary Treating Physician: Dr Garrett Perez MD 
 PATIENT: Jason Scott 
 Date of exam: 2022/22/03 
 Claim #:073818139129-WC-33 
 Insurance: Gallagher Bassett (Corona) 
 doi: 2017/07/10
 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 42 year -old. 
 Job title at time of injury: account manager 
 Current work/Last date of work: working 
 354 Corona. Araceli : Oct 11. 2022 
 page 1
