Bill To:


USAA INSURANCE – MEDICAL CLAIMS
PO BOX 5000
DAPHNE, AL 36526-5000

Services Rendered To:


Heather Carmichael
1301 W. 10th Street
McGregor, Tx 76657-1844
Policy # 0067427177108


Product
Price
Qty
Amount
  1. 406 Medical Extrication – Lvl 2

    Patient;

    Anthony Bumpers

    107 Johnson Street

    McGregor, TX 76657-1844

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 979 San Ann Road - Waco, Texas

Subtotal $1,500.00
Total Due $1,500.00


Updated
May 13, 2022 @ 4:08 pm

Invoice updated by Geoffrey.