Invoice HP-1218

DraftMissing follow-up
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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 · Priya Raman, NP

Invoice

HP-1218

Issued
08-12-2026
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

Priya Raman, NP

Riverside Clinic

DescriptionEnc.QtyUnit priceAmount

Follow-up Visit (20 min)

Follow-up· HP-1002 · CPT 99213

11$95.00$95.00

Nutrition Coaching Program

Packages· HP-4002

  • Follow-up Visit (20 min)
  • Comprehensive Metabolic Panel
  • Vitamin D3 5000 IU (90 ct)— Daily for 90 days
11$129.00$129.00
Subtotal
$224.00
Discounts
−$10.00
Total due
$214.00

Linked encounters

1

08-12-2026 · Metabolic Follow-up

Clinic · Dr. Alicia Chen, MD · Riverside Clinic · note-8488

Assessment

—

Plan

Reschedule at earliest convenience.

Supports:Follow-up Visit (20 min)Nutrition Coaching Program