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INV-202607-001188

Toby Lindqvist

Issued 29 Jul 2026, due 28 Aug 2026

Charges
Charges on invoice INV-202607-001188
ChargeQtyUnitDiscountTaxTotal
Follow-up consultationConsultation · Consultation with Dara Whitfield1$75.00$75.00
Glycated hemoglobinLaboratory · Lab order LAB-2026-0044021$28.00$28.00
Lipid profileLaboratory · Lab order LAB-2026-0044021$35.00$35.00
Metformin 850 mgPharmacy · Dispensed 2 days ago360$0.22$79.20
Amlodipine 5 mgPharmacy · Dispensed 2 days ago180$0.19$34.20
Subtotal
$251.40
Total
$251.40
Insurance covered
-$201.40
Paid
-$50.00
Balance due
$0.00
Payments and refunds

Card payment

AUTH 4417

29 Jul 2026, 15:47 · Remy Castellanos

$50.00
Insurance
Blue Harbor HealthApproved

BHH-4417-8823 · claim CLM-88120

Claimed $201.40 · approved $201.40

Submitted 29 Jul 2026, 15:47 · decided 30 Jul 2026, 15:47