| 04/19/2023 |
| 07:16:46 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| TAPIA ROJAS, MA, UNDEFINED | 8K-3214 | R | 64.00 | 4815********5704 | 125545 | 04/19/2023 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 64.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 64.00 |