Invoice HP-1215

Paid Auto-generated · MB-1003 · cycle 1
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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
Riverside Clinic · Dr. Lena Whitfield, MD

Invoice

HP-1215

Issued
08-15-2026
Payment
Card

Billed to

James Turner

DOB 11-02-1978
77 Harbor View Ln, Oakland, CA 94610
(510) 555-0143 · james.turner@example.com

Rendering provider

Dr. Lena Whitfield, MD

Riverside Clinic

DescriptionEnc.QtyUnit priceAmount

Nutrition Coaching Program

Packages· HP-4002 · Recurring every 30 days

  • Follow-up Visit (20 min)
  • Comprehensive Metabolic Panel
  • Vitamin D3 5000 IU (90 ct)— Daily for 90 days
11$129.00$129.00
Subtotal
$129.00
Total due
$129.00
Paid by Card
$129.00

Linked encounters

1

08-15-2026 · Annual Wellness Evaluation

Procedure · Dr. Alicia Chen, MD · Riverside Clinic · Self-pay · note-8822

Assessment

Healthy adult, routine preventive care.

Plan

Baseline lipid panel. Vitamin D repletion. Annual return.

Supports:Nutrition Coaching Program

Recurring billing

  • Nutrition Coaching Program · every 30 days · membership

Follow-up

Follow-up scheduled with the treating provider.