034975  |  In-Progress
Assigned To: 
Patient Information
PATIENT INFO
Leave Message
Leave Message
Leave Message
ADDRESS
   
Employee Information
HSA Account?
Service Information
Documents
  • Lorem ipsum-dolor-itamet.jpg
    John Smith
    10 July 2017 19:00
  • Lorem ipsum-dolor-itamet.jpg
    John Smith
    10 July 2017 19:00
  • Lorem ipsum-dolor-itamet.jpg
    John Smith
    10 July 2017 19:00
  • Lorem ipsum-dolor-itamet.jpg
    John Smith
    10 July 2017 19:00
  • Lorem ipsum-dolor-itamet.jpg
    John Smith
    10 July 2017 19:00
Quote Activity
Inquiry ID.
Quote. DATE
Service Description Provider Price Member Decision Actions
454673
27 Jul 2017 (21:00)
Colonoscopy Screening AASC of Greenfield
Address1, Address2
City, State Zip
Approx Distance: 15.59 miles
$4000.00

Reject Reason: Reason
454673
27 Jul 2017 (21:00)
Colonoscopy Screening AASC of Greenfield
Address1, Address2
City, State Zip
Approx Distance: 15.59 miles
$4000.00

Reject Reason: Reason
454673
27 Jul 2017 (21:00)
Colonoscopy Screening AASC of Greenfield
Address1, Address2
City, State Zip
Approx Distance: 15.59 miles
$4000.00

Reject Reason: Reason
454673
27 Jul 2017 (21:00)
Colonoscopy Screening AASC of Greenfield
Address1, Address2
City, State Zip
Approx Distance: 15.59 miles
$4000.00

Reject Reason: Reason
454673
27 Jul 2017 (21:00)
Colonoscopy Screening AASC of Greenfield
Address1, Address2
City, State Zip
Approx Distance: 15.59 miles
$4000.00

Reject Reason: Reason
454673
27 Jul 2017 (21:00)
Colonoscopy Screening AASC of Greenfield
Address1, Address2
City, State Zip
Approx Distance: 15.59 miles
$4000.00

Reject Reason: Reason
Referring PROVIDER
PATIENT INFO
FACILITY INFO
   
Provider Information

Carolina Health Care System

  2105 East Enterprise Avenue
     Appleton, WI 54913
15 miles
www.google.com
Bundle Cost

$600

Serivce Desc:

The Orthopedic & Sports Institute of the Fox Valley is the realization of a concept. What would orthopedic care look like if we designed

What's Included:

The Orthopedic & Sports Institute of the Fox Valley is the realization of a concept. What would orthopedic care look like if we designed

Serivce Desc:

The Orthopedic & Sports Institute of the Fox Valley is the realization of a concept. What would orthopedic care look like if

Inernal Use

Carolina Health Care System

  2105 East Enterprise Avenue
     Appleton, WI 54913
15 miles
www.google.com
Bundle Cost

$600

Serivce Desc:

The Orthopedic & Sports Institute of the Fox Valley is the realization of a concept. What would orthopedic care look like if we designed

What's Included:

The Orthopedic & Sports Institute of the Fox Valley is the realization of a concept. What would orthopedic care look like if we designed

Serivce Desc:

The Orthopedic & Sports Institute of the Fox Valley is the realization of a concept. What would orthopedic care look like if

Inernal Use
NOTES AND HISTORY
AHN Admin
25 July 2017 18:00
Requested

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Mauris imperdiet tortor eu sagittis fermentum.

AHN Admin
25 July 2017 18:00
In-Progress

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Mauris imperdiet tortor eu sagittis fermentum.


POST
AHN Admin
25 July 2017 18:00
Re-Open

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Mauris imperdiet tortor eu sagittis fermentum.

AHN Admin
25 July 2017 18:00
Requested

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Mauris imperdiet tortor eu sagittis fermentum.

AHN Admin
25 July 2017 18:00
In-Progress

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Mauris imperdiet tortor eu sagittis fermentum.

AHN Admin
25 July 2017 18:00
Re-Open

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Mauris imperdiet tortor eu sagittis fermentum.