Invoice Doctor General Practitioner in Switzerland Zurich –Free Word Template Download with AI

Limmatstrasse 145

8005 Zurich, Switzerland

Tel: +41 44 123 45 67

Email: [email protected]

Swiss Medical License No: 12345678

VAT ID: CHE-123.456.789 MWST

INVOICE

Invoice No: INV-2023-10-042

Date: October 24, 2023

Due Date: November 24, 2023

Reference: REF-ZH-998877

Patient & Insurance Details

Patient Name: Mr. Thomas Müller

Address: Bahnhofstrasse 10, Apt 4B, 8001 Zurich, Switzerland

Date of Birth: 15.05.1980

AHV Number (Social Security): 756.1234.5678.95

Insurance Provider: Zurich Insurance Group AG

Policy Number: ZH-987654321

Deductible (Franchise): CHF 500.00

Co-payment (Selbstbehalt): 10%

Medical Services Rendered

The following services were provided by Dr. med. Elena Weber, General Practitioner, in accordance with the Swiss Tarmed (TARMED) fee schedule and the Federal Health Insurance Act (KVG/LAMal). All treatments took place at the Zurich clinic premises.

Date	Code	Description of Service	Qty	Unit Price (CHF)	Total (CHF)
24.10.2023	20000	Consultation with General Practitioner (Standard Visit)	1	85.00	85.00
24.10.2023	20001	Extended Consultation (Complex Case Management)	1	145.00	145.00
24.10.2023	10002	Physical Examination (Cardiovascular System)	1	65.00	65.00
24.10.2023	30005	Electrocardiogram (ECG) - 12 Lead	1	95.00	95.00
24.10.2023	40010	Blood Pressure Monitoring & Analysis	1	35.00	35.00
24.10.2023	50020	Prescription Management & Medication Review	1	40.00	40.00
24.10.2023	60005	Referral Letter to Specialist (Cardiology)	1	55.00	55.00

Subtotal: CHF 520.00 VAT (7.7%): CHF 40.04 Total Amount Due: CHF 560.04 Payment Instructions

Please pay the total amount of CHF 560.04 by the due date.

Bank Transfer Details:

Bank: UBS Switzerland AG

IBAN: CH93 0076 2011 6238 5295 7

BIC: UBSWCHZH80A

Reference: INV-2023-10-042

Important Notes regarding this Invoice:

This invoice is issued by a licensed General Practitioner operating within the canton of Zurich, Switzerland.
All medical services listed are compliant with the Swiss Federal Law on Health Insurance (KVG).
Please submit this invoice to your health insurance provider for reimbursement if you have not yet met your annual deductible (Franchise).
If you have a co-payment (Selbstbehalt) clause in your insurance policy, you are responsible for 10% of the reimbursable amount.
In case of any discrepancies regarding the AHV number or insurance details, please contact our practice immediately.
Late payments may incur interest charges in accordance with Swiss debt collection law.
This document serves as an official record of medical consultation and financial transaction.

Thank you for trusting our medical practice in Zurich for your healthcare needs.

[Signature of Dr. med. Elena Weber]
[Official Practice Stamp] ⬇️ Download as DOCX Edit online as DOCX

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