JENNIFER BARON MD - Payment Receipt

[http://www.instamed.com/~noreply]

Title: InstaMed Consumer Email

Hello Robert brown,

Thank you for your recent payment to JENNIFER BARON MD for the amount of $84.03. This email is a receipt and confirms that your account ending in *****6290 has been debited for the amount specified above. We recommend that you retain a copy of this email receipt for your records.

Transaction Information
Date:	July 29, 2023
Amount:	$84.03
Payment Status:	APPROVED
Account Holder Name:	Robert Brown
Routing Number:	075907947
Account Number:	*****6290
Response Code:	100
Authorization Code:	F8B9B4

Thank you,

JENNIFER BARON MD
123 DISALVO AVE # A
SAN JOSE, CA 95128

www.instamed.com
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1880 John F Kennedy Blvd., Philadelphia, PA 19103

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This is the receipt for the request you made to purchase a one-time use virtual prepaid card (“Virtual Card”) to pay your provider. Your account statement will show a purchase from InstaMed. No fees are assessed to you by InstaMed for this payment transaction. In accordance with the InstaMed Payment Terms and Conditions, InstaMed will present your Virtual Card to the provider listed above on your behalf.

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