From:Insight Family Practice

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

To:Michael Heslington

3523 Adams Ave #1
Ogden, UT 84401
US
Phone: (385) 327-9872
Invoice # 14443
Issued on June 26, 2026
Due on July 10, 2026
Balance Due $88.31

Task 1.0

Owed for 1/6/25 appointment (Patient Responsibility)

Rate

$35.45

Qty

1

Amount

$35.45

Task 2.0

Owed for 2/3/25 appointment (co-insurance)

Rate

$26.43

Qty

1

Amount

$26.43

Task 3.0

Owed for 3/3/25 appointment (co-insurance)

Rate

$26.43

Qty

1

Amount

$26.43

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 $88.31 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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