18363 – Owed for 7/21/25 Appointment

From:Insight Family Practice

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

Phone: (801) 997-0368

insightfamilypractice@gmail.com

To:Elizabeth Ayers

11572 S 3420 W
South Jordan, UT 84095
US

Phone: (801) 599-8491

Invoice # 18363

Issued on August 21, 2026

Due on September 4, 2026

Balance Due $59.21

Task 1.0

Owed for 7/21/25 Appointment (co-insurance)

Rate

$59.21

Qty

Amount

$59.21

Total Owed

Subtotal
$59.21
Total
$59.21

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 $59.21 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!

Credit Card

First Name *

Last Name *

Street Address *

Street Address 2

City *

ZIP Code *

State *

Country *

Cardholder Name *

Card Number *

Expiration Date *

Security Code *

Invoice History

Updated 15 days ago

Invoice updated by info@utahwebdesignpros.com.

Viewed 13 days ago

Invoice viewed by 66.249.73.7 for the first time.

Viewed 4 days ago

Invoice viewed by 129.146.230.219 for the first time.