MinuteClinic
Inside CVS Pharmacy #4521
MinuteClinic Health Services
245 Main Street
Chicago, IL 60610
United States
Phone: (312) 555-7842
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Your Health. Our Priority.
Thank You For Visiting MinuteClinic
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Patient Name
Daniel Thompson
Provider
Sarah Johnson, NP
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Date: 4/2/2026
Time: 2:40:52 PM
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1
General Consultation
$99.00
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Subtotal$179.00
Insurance Coverage$-80.00
Tax$0.00
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Payment MethodVisa Credit Card
Card Last 46291
Entry MethodChip
Authorization Code774219
StatusApproved
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1234567890
Please retain this receipt for your records.
For medical history and reports, visit cvs.com.
We wish you good health!
