Paid

Invoice

From:

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

Invoice Number INV-0036
Invoice Date July 13, 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 SANESSH:HPAPRSH

HPA Profile - Urinary NT Salivary Cortisol

$305.000.00%$305.00
1 GP000GP:GPOATGP

Organic Acids Test - 74 Organic Acids

$310.000.00%$310.00
Sub Total $750.00
Tax $0.00
Paid -$750.00
Total Due $0.00