Invoice Dentist in Switzerland Zurich –Free Word Template Download with AI
Dr. med. dent. Elena Müller & Associates
Bahnhofstrasse 45, 8001 Zurich, Switzerland
Phone: +41 44 123 45 67 | Email: [email protected]
VAT ID: CHE-123.456.789 MWST
Swiss Dental Association Member
Invoice Number: ZD-2023-10-892
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Reference: Patient File #8842-A
Billed To (Patient)
Mr. Jonathan Weber
Rämistrasse 112
8006 Zurich, Switzerland
Phone: +41 79 987 65 43
Email: [email protected]
Insurance Details
Primary Insurer: Swiss Life Assurance
Policy Number: SL-99887766
Supplementary Dental Plan: Premium Care
Pre-Approval Ref: PRE-2023-554
Note: This invoice is compliant with Swiss Federal Law on Health Insurance (KVG/LAMal).
| Date | Description of Dental Services | Tariff Code | Unit Price (CHF) | Total (CHF) |
|---|---|---|---|---|
| 2023-10-24 | Comprehensive Oral Examination & Diagnostic Consultation in Zurich Clinic | 10.01 | 120.00 | 120.00 |
| 2023-10-24 | Full Mouth Panoramic X-Ray (OPG) & Bitewing Radiographs | 20.05 | 180.00 | 180.00 |
| 2023-10-24 | Professional Dental Prophylaxis (Scaling & Polishing) - Upper & Lower Arch | 30.10 | 250.00 | 250.00 |
| 2023-10-24 | Composite Resin Filling (Tooth #36) - Occlusal Surface Restoration | 40.22 | 320.00 | 320.00 |
| 2023-10-24 | Local Anesthesia Administration (Lidocaine with Epinephrine) | 50.01 | 45.00 | 45.00 |
| 2023-10-24 | Endodontic Treatment (Root Canal Therapy) - Tooth #14 (Molar) | 60.15 | 850.00 | 850.00 |
| 2023-10-24 | Custom Night Guard Fabrication (Occlusal Splint) for Bruxism Protection | 70.08 | 600.00 | 600.00 |
| 2023-10-24 | Follow-up Consultation & Treatment Plan Review | 10.02 | 90.00 | 90.00 |
Payment Instructions & Important Information
Bank Transfer Details:
Bank: UBS Switzerland AG
IBAN: CH93 0076 2011 6238 5295 7
BIC: UBSWCHZH80A
Reference: Please use Invoice Number ZD-2023-10-892
Credit Card: Visa, Mastercard, and American Express are accepted at our Zurich reception desk.
Terms: Payment is due within 30 days of the invoice date. Late payments may incur interest charges in accordance with Swiss Code of Obligations. Please note that this invoice reflects services rendered at our Zurich clinic and adheres to the Swiss Dental Association's fee guidelines. If you have any questions regarding your insurance coverage or the items listed on this invoice, please contact our billing department immediately. We strive to provide the highest standard of dental care in Switzerland.
Legal Notice: This document serves as an official invoice for tax and insurance purposes in Switzerland. Please retain this document for your records.
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