Invoice Doctor General Practitioner in Turkey Istanbul –Free Word Template Download with AI
Medical Center for Primary Care
Nisantasi District, Sisli
Istanbul, Turkey
Postal Code: 34375
Tax ID (Vergi No): 123 456 78 90
Chamber of Physicians Reg. No: IST-98765
Phone: +90 (212) 555 01 23
Email: [email protected]
INVOICE
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Date of Service: October 24, 2023
Due Date: Upon Receipt
Bill To (Patient)
Name: John Doe
Address: Levent Mahallesi, Büyükdere Caddesi No: 185
City: Istanbul, Turkey
Postal Code: 34330
Phone: +90 (532) 123 45 67
Email: [email protected]
Insurance / Payment Details
Insurance Provider: Private Health Insurance Co.
Policy Number: POL-99887766
Group Number: GRP-12345
Payment Method: Credit Card / Bank Transfer
Bank Name: Is Bankasi A.S.
IBAN: TR00 0006 8000 0000 0000 0000 00
| # | Description of Medical Services | ICD-10 Code | Quantity | Unit Price (TRY) | Total (TRY) |
|---|---|---|---|---|---|
| 1 | General Practitioner Consultation: Comprehensive initial examination by Doctor General Practitioner. Includes history taking, physical examination, and preliminary diagnosis for acute respiratory symptoms. | J06.9 | 1 | 1,500.00 | 1,500.00 |
| 2 | Vital Signs Monitoring: Measurement of blood pressure, heart rate, temperature, and oxygen saturation levels during the visit in Istanbul clinic. | Z00.00 | 1 | 250.00 | 250.00 |
| 3 | Diagnostic Blood Test Panel: Complete Blood Count (CBC) and C-Reactive Protein (CRP) analysis to determine infection markers. | R78.8 | 1 | 800.00 | 800.00 |
| 4 | Throat Swab Test: Rapid antigen test for Streptococcus bacteria performed by the Doctor General Practitioner. | J02.9 | 1 | 450.00 | 450.00 |
| 5 | Prescription and Treatment Plan: Detailed medication prescription and follow-up instructions provided by the Doctor General Practitioner. | Z79.899 | 1 | 300.00 | 300.00 |
| 6 | Clinic Facility Fee: Usage of medical facilities and equipment at the Istanbul medical center. | Z00.00 | 1 | 200.00 | 200.00 |
Payment Terms and Notes:
This Invoice is issued for medical services rendered by a Doctor General Practitioner located in Turkey Istanbul. Payment is expected within 7 days of the invoice date. Please include the Invoice Number (INV-2023-10-045) as a reference when making payments via bank transfer.
Currency: All amounts are stated in Turkish Lira (TRY).
Tax Information: Medical services in Turkey are subject to a reduced Value Added Tax (KDV) rate of 1%.
This has been applied to the subtotal above.
Insurance Claims: If you are submitting this Invoice to your insurance provider, please ensure that all details are legible. Our office can provide additional documentation or ICD-10 coding details upon request.
Follow-Up: Please contact our office if you have any questions regarding this Invoice or your treatment plan. We are committed to providing high-quality healthcare services in Istanbul.
Authorized Signature
Dr. Ahmet Yilmaz
Doctor General Practitioner
Patient Acknowledgement
Signature: ________________________
Date: ________________________
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