Invoice HP-1223

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
Lakeside Clinic · Dr. Lena Whitfield, MD

Invoice

HP-1223

Issued
08-08-2026
Payment
Card

Billed to

Dana Kim

DOB 06-27-1990
1520 Mesa Verde Ct, Austin, TX 78745
(512) 555-0162 · dana.kim@example.com

Rendering provider

Dr. Lena Whitfield, MD

Lakeside Clinic

DescriptionEnc.QtyUnit priceAmount

Physical Therapy Session

Service· HP-1020 · CPT 97110

12$110.00$220.00

Metabolic Care Membership

Packages· HP-4005

  • Comprehensive Evaluation
  • Hemoglobin A1c
  • Lipid Panel
  • Continuous Glucose Sensor— 30-day trial
11$149.00$149.00
Subtotal
$369.00
Total due
$369.00
Paid by Card
$369.00

Linked encounters

1

08-08-2026 · Vitamin D Follow-up

Telehealth · Dr. Alicia Chen, MD · Riverside Clinic · Self-pay · note-8633

Assessment

Vitamin D insufficiency, resolved.

Plan

Switch to maintenance dose 1000 IU daily.

Supports:Physical Therapy SessionMetabolic Care Membership

Follow-up

Follow-up scheduled with the treating provider.