Bill To:


PROGRESSIVE INSURANCE – MEDICAL
6300 WILSON MILLS ROAD
MAYFIELD VILLAGE, OH 44143-2109

Services Rendered To:


Zachary Miles
242 Oak Crest
Huntington, TX 75949
POLICY # 921598051


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

    Patient:

    Zachary Miles
    242 Oak Crest
    Huntington, TX 75949
    POLICY # 921598051

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 790 US Hwy 69S-Hunington, TX

Subtotal $1,500.00
Total Due $1,500.00


Updated
September 21, 2022 @ 12:31 pm

Invoice updated by Geoffrey.