Bill To:


Merry Elliott
1209 Beeblossom Drive
Desoto, TX 75115

Services Rendered To:


Merry Elliott
1209 Beeblossom Dr.
Desoto, Texas 75115
Policy # 66639539854


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND IGNORED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    Patient:

    Maria Rodriguez
    223 Buffalo
    Glen Heights, Tx 75154

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 223 S.B. / Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization Item # 7

Subtotal $1,500.00
Total Due $1,500.00


Updated
March 11, 2021 @ 2:34 pm

Invoice updated by Geoffrey.

Updated
September 29, 2021 @ 5:25 pm

Invoice updated by Geoffrey.

Updated
September 29, 2021 @ 5:25 pm

Invoice updated by Geoffrey.

Updated
September 29, 2021 @ 5:38 pm

Invoice updated by Geoffrey.

Updated
September 29, 2021 @ 5:39 pm

Invoice updated by Geoffrey.

Viewed
October 25, 2022 @ 9:42 am

Invoice viewed by 64.124.8.56 for the first time.