Example Medicare Supplement Lead

Lead Number: 5008800
Lead Type: Medicare Supplement
Date Received: 01/31/2005

Contact Information:
Name: Ronald Brewer
Address: 5010 Honeygate Drive
City: Huber Heights
State: OH
Zip Code: 45424
Phone: 937-718-0056
Email: ronbrewer_2000@yahoo.com

Policy Information:
Level(s) to Quote: Show me options
Currently Insured: yes
Current Carrier: private information
Insured Information:
Age: 75
Age Spouse: 74
Tobacco Use: No
High Blood Pressure: No

Other Information and Medical Conditions:

I am looking for a medicare supplement that will pickup any remaining balances to part a & part b along with an interest for a medicare approved discnt drug card.