Thanks for providing such a detailed explanation, @bakerchambliss.
Currently, QuickBooks Online (QBO) does not offer the ability to create an invoice directly from a bank transaction while you're reconciling.
From what you've described, it sounds like you're trying to generate invoices for each healthcare practice based on purchases that appear in your bank feed.
If your goal is to record the transaction, you don't need to create an invoice. Instead, you can directly categorize your transaction under the correct sales category. You can visit this article to learn more about Categorization in QBO: Categorize online bank transactions in QuickBooks Online.
However, if you need to bill each practice for those purchases, you'll need to create an invoice manually. You can visit this article to learn how to create an invoice in bulk: Create and send multiple invoices.
If you need further help as you proceed, let us know by filling in the comments.
