Paid

Invoice

From:

6144 Pleasant Dream St.
North Richland Hills, TX 76180
817.797.7475
Sharon R. Price, Ph.D., CN

Invoice Number INV-0142
Invoice Date April 23, 2020
Total Due $500.00
To:
Cherry Burns

4925 Bateman Rd.
Ft. Worth, TX 76244

Hrs/Qty Service Rate/PriceAdjustSub Total
1 CPT97803

Medical Nutrition Therapy - Follow-Up Assessment

$135.000.00%$135.00
1 GP000GP:GPCSAGP

Comprehensive Stool Analysis with Parasitology

$365.000.00%$365.00
Sub Total $500.00
Tax $0.00
Total Due $500.00