Paid

Invoice

From:

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

Invoice Number INV-0099
Invoice Date July 24, 2019
Total Due $0.00
To:
JoAnn Hill c/o Phyllis Wright

1239 Regents Park Ct.
DeSoto, TX 75115

Phyllis Wright, daughter has Medical Power of Attorney

Hrs/Qty Service Rate/PriceAdjustSub Total
1 CPT97802

Medical Nutrition Therapy - Initial Assessment - 30 minute consult on July 16

$70.000.00%$70.00
1 CPT97803

Medical Nutrition Therapy - Follow-Up Assessment - 60 minute consult on July 24

$135.000.00%$135.00
Sub Total $205.00
Tax $0.00
Paid -$205.00
Total Due $0.00