From:Insight Family Practice

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

To:Nicole Sanders Whitesel

629 E 700 N
Springville, UT 84663
US
Phone: (801) 888-0885
Invoice # 11297
Issued on February 9, 2026
Due on March 2, 2026
Balance Due $431.47

Task 1.0

Due for Ketamine Treatment Date of Service: 4/18/2024 – Patient did not have active Aetna insurance coverage as primary

Rate

$346.57

Qty

1

Amount

$346.57

Task 2.0

Due for Ketamine Treatment Date of Service: 6/26/2024 – Patient did not have active Aetna insurance coverage as primary

Rate

$84.90

Qty

1

Amount

$84.90

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.

Balance of $431.47 is Overdue Make a Payment

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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 66 days ago

Status changed: Draft to Pending.

Status Update 66 days ago

Status changed: Draft to Pending.

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Updated 59 days ago

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