From:Insight Family Practice

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

To:Kylie Smith

2133 North 1930 West
Clearfield, UT 84015
US
Phone: (385) 789-4002
Invoice # 6034
Issued on October 2, 2025
Due on November 2, 2025
Balance Due $60.00

Task 1.0

01/28/2025 Office Visit: Patient Responsibility

Rate

$30

Qty

1

Amount

$30

Task 2.0

04/01/2025 Office Visit: Patient Responsibility

Rate

$30

Qty

1

Amount

$30

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 $60.00 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

Status Update 283 days ago

Status changed: Draft to Pending.

Status Update 283 days ago

Status changed: Draft to Pending.

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