Jerry Mcintosh

 
 From: Stephanie Gonzales 
 Fax: 16554652650 
 To: 
 Fax: (465) 658-5655 
 Page: 2 of 20 
 03/15/2022 8:55 PM 
 POWERED BY 
 DaisyBill 
 From 
 Stephanie Gonzales 
 To 
 Subsequent Injuries Benefits Trust  
 Original Bill 
 Med Legal 
 PATIENT NAME 
 Jerry Mcintosh
 Billing Provider 
 MED-LEGAL 
 Claim Number 
 SIF65436558 
 DOS 
 2023 May 22 
 Patient Control No. 
 1065db7656465-1 
 Charge Amount 
 $10,238.00
 DaisyBill.com 
 info@daisybill.com 
 (665) 865-7651 
 DaisyBill does not respond to incoming faxes. Please call or email.