Details
- Category
- Vendor
- Optical Shop Inc
- Amount
- $0.00
- Date
- Jan 19, 2024
- Processed
- Sep 08, 2026 6:09 PM EDT
- Original File
- Scan_09082026_144014_000257.pdf
Summary
Statement of charges and payments from Optical Shop Inc for patient Johan Jongsma (Patient #14973), fee slip 102661, dated 01/19/2024. Total charges $624.00 were fully paid by Mastercard; balance due $0.00, no payment necessary.
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