Your receipt from Retinal Diagnostic Center

[Retinal Diagnostic Center <http://www.chat.inboxhealth.com/~customerservice>]

Title: Your receipt from Retinal Diagnostic Center

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Payment Receipt

Robert Payment
Made on July 10, 2022, 1:40 PM
Paid to Retinal Diagnostic Center
Campbell, CA
Reference Number: 103499247
Your Payment	$60

Services paid for:

Name	Date	Charged	Covered	Balance
EYE EXAM&TX ESTAB PT 1/>VST	June 09, 2022	$243	$0	$243
WRITE OFF - INSURANCE	June 22, 2022	$0	$53.10	$-53.10

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Retinal Diagnostic Center

3395 S. Bascom Ave. #140 Campbell, CA 95008

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Attachment: payment_receipt.pdf
Description: Adobe PDF document