Paid

Invoice

From:

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

Invoice Number INV-0058
Invoice Date September 26, 2018
Total Due $0.00
To:
Dan Ahlers

1445 Shady Oaks Dr.
Southlake, TX 76092

Hrs/Qty Service Rate/PriceAdjustSub Total
1 CPT97803

Medical Nutrition Therapy - Follow-Up Assessment

$135.000.00%$135.00
1 Total Leaky Gut

60 capsules

$30.000.00%$30.00
Sub Total $165.00
Tax $0.00
Paid -$165.00
Total Due $0.00