From:Insight Family Practice

8686 S 1300 E, Suite L102-104
Sandy, UT 84094
US
Phone: (801) 997-0368
insightfamilypractice@gmail.com

To:Seth (Bella) Martin

3966 W Dear Dr.
Apt.A
West Valley City, UT 84120
US
Phone: (385) 600-9522
Invoice # 16528
Issued on August 6, 2026
Due on August 20, 2026
Balance Due $65.00

Task 1.0

Owed for 2/27/25 Appointment (co-insurance)

Rate

$65

Qty

1

Amount

$65

Total Owed

Info & Notes

Thank you; we really appreciate your business.

Terms & Conditions

We do expect payment within 21 days, so please process this invoice within that time. There will be a 1.5% interest charge per month on late invoices.

Balance of $65.00 is Overdue Make a Payment

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