From:Insight Family Practice

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

To:Brian Simons

285 N 400 E
Payson, UT 84651
US
Phone: (385) 283-3343
Invoice # 16395
Issued on August 4, 2026
Due on August 18, 2026
Balance Due $68.66

Task 1.0

Owed for 6/27/25 Appointment (co-insurance)

Rate

$68.66

Qty

1

Amount

$68.66

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 $68.66 Due in 2 Days 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

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