Bill To:


GEICO INSURANCE – MEDICAL
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Deaundre Holman
2412 Crescent Dr
Killeen, TX 76543
POLICY# 6125727401


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

    Patient

    Deaundre Holman
    2412 Crescent Dr
    Killeen, TX 76543
    POLICY# 6125727401

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 521- Rosharon, TX

    Ordinance Info: Rosharon Cost Recovery Resolution

Subtotal $1,500.00
Total Due $1,500.00


Updated
December 12, 2023 @ 11:36 am

Invoice updated by Geoffrey.

Viewed
March 30, 2024 @ 12:33 am

Invoice viewed by 66.249.72.5 for the first time.