Invoice Ophthalmologist in Germany Munich –Free Word Template Download with AI
Maximilianstraße 42
80539 Munich, Germany
Phone: +49 (0) 89 123 456 78
Email: [email protected]
Chamber Number: 12345 (Ärztekammer Bayern)
Tax ID: DE 123 456 789
INVOICE
Billed To (Patient):Mr. Thomas Müller
Ludwigstraße 15, Apt 4B
80539 Munich, Germany
Insurance Provider:AOK Bayern
Insurance No: AOK-987654321
Group No: 12345
Services Rendered - Ophthalmology Consultation| Code | Description of Ophthalmological Service | Qty | Unit Price (€) | Total (€) |
|---|---|---|---|---|
| 01700 | Comprehensive Ophthalmological Examination including visual acuity testing, slit-lamp biomicroscopy, and fundus examination. Performed at our Munich clinic. | 1 | 45.00 | 45.00 |
| 02300 | Diagnostic Perimetry (Visual Field Test) to assess peripheral vision and detect glaucoma or neurological deficits. | 1 | 35.50 | 35.50 |
| 03100 | Optical Coherence Tomography (OCT) of the retina and optic nerve head for high-resolution cross-sectional imaging. | 1 | 65.00 | 65.00 |
| 04500 | Prescription of corrective lenses (Glasses) based on refraction analysis conducted during the ophthalmologist visit. | 1 | 15.00 | 15.00 |
| 05200 | Follow-up consultation regarding post-operative care after cataract surgery performed in Munich. | 1 | 30.00 | 30.00 |
| 06100 | Specialized Glaucoma Management Plan including intraocular pressure monitoring and medication adjustment. | 1 | 55.00 | 55.00 |
Please remit payment within 30 days of the invoice date. Payments can be made via bank transfer to the following account:
Bank Name: Bayerische Landesbank
IBAN: DE89 7005 0000 0000 1234 56
BIC: BYLADEM1001
Reference: INV-2023-10-089 / T. Müller
Important Notes for Patients in Germany- This invoice reflects services provided by a certified Ophthalmologist in Munich, Germany, in accordance with the German Fee Schedule for Physicians (GOÄ) and statutory health insurance regulations.
- If you have private health insurance (PKV), please submit this invoice directly to your provider for reimbursement. We can provide a detailed cost breakdown upon request.
- For statutory insurance (GKV), the patient share (Zuzahlung) has been calculated based on current regulations. A maximum annual contribution limit may apply.
- Please retain this document for your personal records and tax purposes. Medical invoices in Germany are valid for seven years.
- If you have any questions regarding the ophthalmological procedures listed, please contact our practice in Munich during business hours (Mon-Fri, 8:00 AM - 5:00 PM).
- Payment delays may result in a reminder fee as per German commercial law (§ 288 BGB).
Authorized Signature:
Dr. med. Elena Weber
Ophthalmologist
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