Patient Information

Name: Diana Wilson

MRN: MRN105

Email: diana.wilson@example.test

Phone: +1555200005

Invoice Information

Invoice Date: 10/04/2025

Due Date: 09/11/2025

Status: Overdue

Total Amount: $150.00

Balance: $150.00

Created: 10/4/2025 4:24 PM by BillingAutomationService

Description

Invoice for appointment on 2025-08-12

Notes

Generated automatically for completed appointment: Lab Review

Payment Summary

$0.00

Paid

$150.00

Balance
Line Items
Description Quantity Unit Price Total Service Date
Appointment: Lab Review 1.00 $150.00 $150.00 08/12/2025
Total: $150.00