Statement ready
Due July 15, 2025
Your balance
$540.00
Total charged$890.00
Your insurance paid-$350.00
You owe$540.00
What this is for
Lab Work — Comprehensive Panel
Visit: May 28, 2025
$540.00 was not covered by insurance. This may be due to your deductible, plan limits, or the service not being covered. You have 60 days to appeal.
Visa
•••• 7743
Common questions
Need help?
Call billing: (800) 555-0100 · Mon–Fri 8am–5pm