Invoice Ophthalmologist in Italy Naples –Free Word Template Download with AI
Specialized Ophthalmology Center
Via Toledo, 250, 80134 Napoli, Italy
P.IVA / C.F.: IT01234567890
Email: [email protected]
Phone: +39 081 123 4567
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Service Date: October 20, 2023
Bill To:
Mr. Alessandro Rossi
Via Chiaia, 120
80132 Napoli, Italy
Codice Fiscale: RSSLSN80A01H501U
Health Insurance Provider: Sanitas (Policy #998877)
| # | Description of Ophthalmological Services | Unit Price (€) | Total (€) | IVA (22%) |
|---|---|---|---|---|
| 1 |
Comprehensive Ophthalmological Examination Includes visual acuity testing, refraction, slit-lamp examination, and intraocular pressure measurement (Tonometry) performed at our Naples clinic. |
120.00 | 120.00 | 26.40 |
| 2 |
Dilated Fundus Examination Detailed inspection of the retina, optic nerve, and macula using mydriatic drops to assess ocular health and screen for diabetic retinopathy. |
80.00 | 80.00 | 17.60 |
| 3 |
Optical Coherence Tomography (OCT) High-resolution cross-sectional imaging of the retina to detect early signs of macular degeneration or glaucoma. |
150.00 | 150.00 | 33.00 |
| 4 |
Corneal Topography Mapping of the corneal surface curvature to evaluate astigmatism and suitability for refractive surgery. |
90.00 | 90.00 | 19.80 |
| 5 |
Prescription for Corrective Lenses Issuance of official prescription for glasses or contact lenses following the refraction test. |
25.00 | 25.00 | 5.50 |
Payment Instructions
Please remit payment within 30 days of the invoice date. Payments can be made via bank transfer or credit card at our Naples office.
Bank Name: Banca Intesa Sanpaolo
IBAN: IT60 X030 6909 6061 0000 0012 345
BIC/SWIFT: BCITITMM
Reference: Please use Invoice Number INV-2023-10-045 as the payment reference.
Important Notes & Legal Information
This invoice represents the professional fees for ophthalmological services rendered by Vision Care Naples, a specialized medical facility located in the heart of Naples, Italy. All prices listed are in Euros (€) and are subject to the standard Italian Value Added Tax (IVA) rate of 22%, as per current Italian fiscal regulations.
Medical Disclaimer: The services described herein are for diagnostic and consultation purposes only. This invoice does not constitute a guarantee of specific medical outcomes. Any surgical procedures or advanced treatments discussed during the consultation are subject to separate consent forms and pricing agreements.
Insurance Claims: If you are submitting this invoice to your health insurance provider (e.g., Sanitas, AXA, or private mutual funds), please ensure that the original document is signed by the attending ophthalmologist. Our clinic in Naples is accredited to provide receipts compliant with Italian tax laws for reimbursement purposes.
Privacy Policy: Your personal and medical data are processed in accordance with the General Data Protection Regulation (GDPR) and Italian privacy laws (D.Lgs. 196/2003). Your information is kept strictly confidential and used solely for medical and billing purposes.
Late payments may incur a statutory interest charge as defined by Italian law. For any discrepancies regarding this invoice, please contact our billing department in Naples within 15 days of receipt. We appreciate your trust in our ophthalmological care.
Authorized Signature
Dr. Marco BianchiLead Ophthalmologist
Vision Care Naples ⬇️ Download as DOCX Edit online as DOCX
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