From:Insight Family Practice

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

To:John Amtoft

3338 S 700 E
Salt Lake City, UT 84106
US
Phone: (385) 371-0792
Invoice # 14423
Issued on June 24, 2026
Due on July 8, 2026
Balance Due $92.45

Task 1.0

Co-insurance for appointment on 1/2/25

Rate

$1.79

Qty

1

Amount

$1.79

Task 2.0

Co-insurance for appointment on 1/30/25

Rate

$30

Qty

1

Amount

$30

Task 3.0

Co-insurance for appointment on 5/22/25

Rate

$60.66

Qty

1

Amount

$60.66

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 $92.45 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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