Bill To:


AAA Texas County Mutual Insurance
3333 Fairview Road
Costa Mesa, CA 92626

Services Rendered To:


Jennifer Walker
7700 Ranch Road
Athens, Texas 75751
Policy # TPA0706057


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

    Patient:

    Garrett Brown
    7589 Weeping Willow
    Big Sandy, Texas 75755

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6322 Highway 64 - Ben Wheeler, Texas

Subtotal $1,500.00
Total Due $1,500.00


Updated
July 1, 2021 @ 12:18 am

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 2:25 pm

Invoice viewed by 64.124.8.25 for the first time.