| 05/18/2016 |
| 09:39:56 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| HEFLEY, LYNN, | Q1-27414 | R | 52.00 | 4388********9652 | 07304C | 05/18/16 |
| SHERMAN III, DO, | Q1-27756 | R | 45.00 | 4388********9922 | 07305C | 05/18/16 |
| THOMPSON, SCOTT, | Q1-24470 | R | 69.00 | 5403********4258 | 082910 | 05/18/16 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 69.00 |
| 2 | Visa | 97.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 166.00 |