vault backup: 2026-04-05 17:46:47

documents/medical/eye/jiang_eye_exam_receipt_12_2025.md

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+---
+type: receipt
+category: eye
+person: Xuewei Jiang
+date: 2025-12-29
+provider: Del Rey Optometry Marina Del Rey
+source: jiang_eye_exam_receipt_12_2025.HEIC
+---
+
+# Eye Exam Receipt — Xuewei Jiang — 12/29/2025
+
+## Store Information
+
+- **Store:** Del Rey Optometry Marina Del Rey 10
+- **Address:** 4266 Lincoln Blvd., Marina Del Rey, CA 90252-5618, United States
+- **Phone:** 310-823-4595
+
+## Receipt Details
+
+- **Receipt #:** 3010062
+- **Date:** 12/29/25 @ 10:10 AM
+- **Store:** 29010 | Register: 3
+- **Cashier:** Paola 330031
+- **Salesperson:** 330031 (Paola)
+- **Order For:** Xuewei (Erica) Jiang
+- **Sales Order:** 10122841429010
+
+## Line Items
+
+| Item | Qty | Price | Amount |
+|------|-----|-------|--------|
+| 92015 Refraction (20500001669638) | 1 | 59.00 | 17.90 |
+| 4321-INSURANCE DISCOUNT | | | (41.10) |
+| Sales Order 10122841429010 [Doctor Service Addon] | | | |
+| Optomap (20500001865028) | 1 | 29.00 | 20.00 |
+| 4321-INSURANCE DISCOUNT | | | (19.00) |
+| Sales Order 10122841429010 [Doctor Service Addon] | | | |
+| 92014 Est Comprehensive (20500001982051) | 1 | 159.00 | 71.60 |
+| 4321-INSURANCE DISCOUNT | | | (87.40) |
+| Sales Order 10122841429010 [Doctor Service] | | | |
+| ADD-ON ONLY PACKAGE ARTICLE | | | |
+
+## Totals
+
+| | Amount |
+|---|--------|
+| Subtotal | 109.50 |
+| Tax | 0.00 |
+| **Total** | **109.50** |
+
+## Payment
+
+| | Amount |
+|---|--------|
+| Assignment Vision Care (10122841429010) | 79.50 |
+| Visa 7257 | 30.00 |
+| Auth #: | |
+| Transaction Type: Sale | |
+| Entry Method: Keyed | |
+| Auth Time: 10:10 AM | |
+| **Change** | **0.00** |
+
+## Notes
+
+> Guarantee: Our goal is 100% satisfaction! If you're not completely satisfied with your purchase within the first 30 days, just let us know. We're committed to making it right.
+
+Total Item(s) purchased: 3
+
+*Customer Copy*