From:Insight Family Practice

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

To:Shane Alires

6218 S Gold Medal Dr.
Salt Lake City, UT 84129
US
Phone: (385) 371-2526
Invoice # 17077
Issued on August 10, 2026
Due on August 24, 2026
Balance Due $29.67

Task 1.0

Owed for 5/7/25 Appointment (co-insurance)

Rate

$29.67

Qty

1

Amount

$29.67

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 $29.67 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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Invoice History

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