1.8 KiB
1.8 KiB
type, category, person, date, provider, source
| type | category | person | date | provider | source |
|---|---|---|---|---|---|
| receipt | eye | Xuewei Jiang | 2025-12-29 | Del Rey Optometry Marina Del Rey | 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