Paid

Invoice

From:

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

Invoice Number INV-0091
Invoice Date June 10, 2019
Total Due $0.00
To:
Jennifer Clements

1125 Longford Cir
Southlake, TX 76092

Hrs/Qty Service Rate/PriceAdjustSub Total
1 CPT97803

Medical Nutrition Therapy - Follow-Up Assessment 40 minutes

$95.000.00%$95.00
Sub Total $95.00
Tax $0.00
Paid -$95.00
Total Due $0.00