From:Insight Family Practice

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

To:Rachel Charon

6944 S La Rosa Ct
Salt Lake City, UT 84121
US
Phone: (916) 865-7600
Invoice # 16391
Issued on August 4, 2026
Due on August 18, 2026
Balance Due $20.11

Task 1.0

Owed for 2/6/25 Appointment (co-insurance)

Rate

$10.10

Qty

1

Amount

$10.10

Task 2.0

Owed for 3/6/25 Appointment (co-insurance)

Rate

$10.01

Qty

1

Amount

$10.01

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 $20.11 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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