"First Name" field is required.

"Last Name" field is required.

"Street Address" field is required.

"City" field is required.

"ZIP Code" field is required.

"State" field is required.

"Country" field is required.

"Cardholder Name" field is required.

"Card Number" field is required.

"Expiration Date" field is required.

"Security Code" field is required.

E00003 The element 'creditCard' in namespace 'AnetApi/xml/v1/schema/AnetApiSchema.xsd' has invalid child element 'expirationDate' in namespace 'AnetApi/xml/v1/schema/AnetApiSchema.xsd'. List of possible elements expected: 'cardNumber' in namespace 'AnetApi/xml/v1/schema/AnetApiSchema.xsd'.

Payment Pending

20657 – Owed for 6/18/26 Blood Draw

From:Insight Family Practice

8686 S 1300 E, Suite L102-104
Sandy, UT 84094
US

Phone: (801) 997-0368

insightfamilypractice@gmail.com

To:James Kennedy

18 WindSong
Sandy, UT 84092
US

Phone: (801) 635-8307

Invoice # 20657

Issued on September 30, 2026

Due on October 14, 2026

Balance Due $154.10

Task 1.0

Owed amount for blood draw on 6/18/26 (Selfpay)

Rate

$154.10

Qty

Amount

$154.10

Total Owed

Subtotal
$154.10
Total
$154.10

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 $154.10 is Overdue Make a Payment

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First Name *

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Street Address 2

City *

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Cardholder Name *

Card Number *

Expiration Date *

Security Code *

Invoice History

Updated 23 days ago

Invoice updated by info@utahwebdesignpros.com.

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