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HomeMy WebLinkAboutInv# 2469914 - MEDICAL DECISION, LLC - 06/20/2023Patient Portal □ Register and manage your account online ... View and pay invoices securely • Track your payments e Pay online at: medicaldecisions.hmebillpay.com 0 Important Messages • Any insurance provided has been applied, please reference your EOB. • The balance shown is your responsibility . • A service charge may apply if payments are late. Q) Billing Questions Monday Friday (954) 772-1631 8 :30 am 5:00 pm 140421-MIN V• 1-90 77 -49843 Payments not accepted at this address Medical Decision Services PO Box 1259 Dept# 140418 Oaks, PA 19456 111111111111111 IIIIIII I IIII II IIIII IIIIIIIIIII II I II I II Ill , 111, 1,, 111,,,,,,,,, 1,, 11,, I, I 11, I I I 11 '1,,,,, 11, 11,, 1111,,,,,,,, 1 R~ . CITY OF DANIA BEACH b!i 100 W DANIA BEACH BLVD DANIA FL 33004-3643 ~~ 1or1 Medical Decision Services 2890 W State Road 84 , Ste 102 Fort Lauderdale FL 33312-4828 e Pay online at: medicaldecisions.hmebillpay.com Account Number: Due by: 63874 Jul10,2023 Patient Name: Patient owes: . City of Dania Beach $5000.00 Date Mailed : Jun 20, 2023 Invoice 2469914 DATE DESCRIPTION AMOUNT 02/03/2023 NOVAERUS AIR FILTRATION FOR MEDIUM SIZED SPACES 02to3t2023 NV900 WARRANTY $4800.00 $200.00 Total: $5000.00 ~ LQ-Jv-J3 u)~s(. (\~J Oo l ,.. l\-o ( -S l l -3 \-· t'b CC> I -l 3 -o l -S\ ~ -S \-l 0 Q93D ~()D ---.......,---------..,..,.- Invoice Total •. Previously Billed · A Total Due '-$5000.00__ L___ ~.00 ~ __ ,,_ $5000.00 PLEASE DETACH HERE AND RETUR N BOTTOM PORT ION T Cards Accepted Late after. Jul 10, 2023 Patient owes: $5000.00 VISA Card Number ----- - -1 Securlty Code -------------------------- Amount Enclosed BIiiing Zip Code Signature Account#: 63874 lnvoice(s): 2469914 Mail Payment to: Medica l Decision Services 2890 W State Road 84 , Ste 102 Fort Lauderdale FL 33312-4828 1111•11••11 1111•1111 1•11••11•111•111 111•11•11 11•1•1•111 1111 111•11