Invoice HP-1210

Paid
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Patient accountCredit available $0.00Balance owed $0.00
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Luminary Health

Luminary Health Partners, PLLC

2200 Riverside Parkway, Suite 310, Austin, TX 78701
(512) 555-0142 · billing@luminaryhealth.com
Northgate Clinic · Priya Raman, NP

Invoice

HP-1210

Issued
08-19-2026
Payment
Cash

Billed to

Andre Lewis

DOB 01-19-1955
309 Birch Hollow Rd, Cedar Park, TX 78613
(737) 555-0119 · andre.lewis@example.com

Rendering provider

Priya Raman, NP

Northgate Clinic

DescriptionEnc.QtyUnit priceAmount

Magnesium Glycinate (60 ct)

Product· HP-3004

Sig: Nightly, 60 day supply

11$24.00$24.00

Lipid Panel

Diagnostics· HP-2015 · CPT 80061

21$52.00$52.00
Subtotal
$76.00
Discounts · Fall Wellness Diagnostics
$7.80
Total due
$68.20
Paid by Cash
$68.20

Linked encounters

1

08-06-2026 · Metabolic Follow-up

Clinic · Dr. Alicia Chen, MD · Riverside Clinic · Insured (Zing Health) · note-8841

Assessment

1. Prediabetes, improving with lifestyle change. 2. Fatigue, likely multifactorial; vitamin D insufficiency suspected. 3. Overweight with metabolic risk.

Plan

Repeat metabolic labs today. Begin vitamin D repletion. Enroll in nutrition coaching for structured carbohydrate guidance. Trial continuous glucose sensor for 30 days to identify postprandial patterns. Recheck in 6 weeks.

Supports:Magnesium Glycinate (60 ct)
2

08-19-2026 · Lab Review

Clinic · Dr. Alicia Chen, MD · Riverside Clinic · Self-pay · note-8740

Assessment

Healthy adult; labs normal.

Plan

No changes. Continue annual screening.

Supports:Lipid Panel

Follow-up

Follow-up scheduled with the treating provider.