Organization Name: Planned Parenthood
Organization Tagline: Care. No matter what.
Address Line 1: 123 Health Services Way
Address Line 2: —
City, State, Zip: New York, NY 10001
Phone: 1-800-230-7526
Website: www.plannedparenthood.org
Email: [email protected]
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Transaction Type: Healthcare Services
Visit Reference ID: PP-VIS-20251112-004981
Receipt ID: PP-REC-20251112-004981
Payment Status: Completed
Service Date & Time: 11/12/2025 10:37:25 AM
Payment Method: Debit Card
Card: Visa ending 4922
Authorization Code: PP-AUTH-6H72F9
Reference Number: PP20251112R004981
Currency: USD
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Patient Name:
Samantha Lee
Clinic Location:
Planned Parenthood Health Center
Provider:
Planned Parenthood
Billing Address:
742 Evergreen Terrace, Apt 9C, Springfield, IL 62704, United States
Visit Type:
In-Clinic Appointment
Visit Reference ID:
PP-VIS-20251112-004981
10/09/2026, 12:35:47 PM
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1
Clinical Consultation & Evaluation
$120.00
1
Preventive Health Services
$85.00
1
Laboratory & Screening Services
$62.50
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Subtotal$267.50
Discount(10%)$26.75
Tax(9%)$21.67
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Card Number**** **** **** 4922
Card TypeDebit
Card EntryChip
Date/Time11/20/2019 11:09 AM
Reference #62845289260246240685C
StatusAPPROVED
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Receipt Number: PP-2025-1112-009
Patient Support: 1-800-230-7526
Help Center: www.plannedparenthood.org/learn
Thank you for trusting Planned Parenthood with your care.
Privacy Notice: Your health information is protected under applicable privacy laws.
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