Bill To:


NATIONWIDE INSURANCE – MEDICAL
PO BOX 26005
DAPHNE, AL 36526-5005

Services Rendered To:


Mohammad Eljindi
6308 Windcrest Dr. #2924
Plano, Texas 75024
Policy # 7842J189845


Product
Price
Qty
Amount
  1. 405 Medical Extrication – Lvl 1

    Patient:

    Mohammad Eljindi
    6308 Windcrest Dr. #2924
    Plano, Texas 75024
    Policy # 7842J189845

    $500.00
    1
    $500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: MM 217 Northbound on Interstate 45N

    Ordinance Info: City of Angus Billing Authorization Item # 7

Subtotal $500.00
Total Due $500.00


Updated
July 15, 2021 @ 3:12 pm

Invoice updated by Geoffrey.

Updated
July 15, 2021 @ 3:16 pm

Invoice updated by Geoffrey.

Viewed
September 14, 2022 @ 11:11 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.