Luminary Health
Luminary Health Partners, PLLC
2200 Riverside Parkway, Suite 310, Austin, TX 78701
(512) 555-0142 · billing@luminaryhealth.com
Northgate Clinic · Dr. Alicia Chen, MD
Invoice
HP-1204
- Issued
- 08-25-2026
- Payment
- Not collected
Billed to
Sofia Patel
DOB 09-08-1984
88 Sunrise Terrace, Berkeley, CA 94705
(510) 555-0174 · sofia.patel@example.com
Rendering provider
Dr. Alicia Chen, MD
Northgate Clinic
| Description | Enc. | Qty | Unit price | Amount |
|---|---|---|---|---|
Vitamin D3 5000 IU (90 ct) Product· HP-3001 · Recurring every 90 days Sig: Daily for 90 days | 1 | 1 | $28.00 | $28.00 |
Physical Therapy Session Service· HP-1020 · CPT 97110 | 1 | 1 | $110.00 | $110.00 |
- Subtotal
- $138.00
- Total due
- $138.00
Linked encounters
08-25-2026 · Lab Review
Clinic · Dr. Alicia Chen, MD · Riverside Clinic · note-8712
Assessment
Prediabetes, stable.
Plan
Continue lifestyle measures. Repeat labs in 3 months.
Recurring billing
- Vitamin D3 5000 IU (90 ct) · every 90 days · membership
Follow-up
Follow-up scheduled with the treating provider.