From:Insight Family Practice

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

To:Lai Sim Pollyanna Chan

12307 S Big Bend Vista Dr.
Herriman, UT 84096
US
Phone: (801) 995-3074
Invoice # 6030
Issued on October 2, 2025
Due on November 2, 2025
Balance Due $60.27

Task 1.0

01/27/2025 Office Visit: Patient Responsibility

Rate

$60.27

Qty

1

Amount

$60.27

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 $60.27 is Overdue Make a Payment

Make a Payment

Please enter your payment information to pay this invoice. A receipt for your records will be sent to you. Thank you very much!

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Invoice History

Status Update 209 days ago

Status changed: Draft to Pending.

Updated 209 days ago

Invoice updated by Insight Family Practice.

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