========= GENERAL INFORMATION =========
Merchant : GERMEDUSA INC (2362778)
Date/Time : 16-Dec-2025 9:45:13 PST

========= ORDER INFORMATION =========
Invoice : 207
Description : GerMedUSA Invoice GM 4754
Amount : 778.79 (USD)
Payment Method: Visa xxxx4686
Transaction Type: Authorization and Capture

============== Line Items ==============
Item: G45-422
Description: Mixter Thoracic Forc Right 11
Quantity: 1
Unit Price: $260.39 (USD)
Item Total: $260.39 (USD)
Item: G45-420
Description: Mixter Thoracic Forc Right 9
Quantity: 2
Unit Price: $219.95 (USD)
Item Total: $439.90 (USD)

============== RESULTS ==============
Response : This transaction has been approved.
Auth Code : 509567
Transaction ID : 121390671958
Address Verification : Street Address: Match -- First 5 Digits of Zip: Match

==== CUSTOMER BILLING INFORMATION ===
Customer ID : 791477724
First Name : Chad
Last Name : Lewis
Company : 
Address : 352 W Aster Lane
City : Chandler
State/Province : Arizona
Zip/Postal Code : 85248
Country : US
Phone : 6177806164
Fax : 
E-Mail : chad@costasurgical.com