| 08/21/2019 |
| 06:49:04 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| CAGGIANELLI, DO, | 9R-WEB2965275 | R | 6.00 | 4403********1119 | 662694 | 08/21/2019 |
| NAVARRO, ABIGAI, | 9R-5KSZ162814 | R | 6.00 | 5205********5137 | 539018 | 08/21/2019 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 6.00 |
| 1 | Visa | 6.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 12.00 |