Invoice Ophthalmologist in Japan Osaka –Free Word Template Download with AI
2-5-18 Umeda, Kita-ku, Osaka, 530-0001, Japan
Tel: +81-6-6345-8899 | Fax: +81-6-6345-8800
Email: [email protected]
Medical License No: Osaka-Med-2024-OPH-992
Invoice Number: INV-2024-10-045
Date Issued: October 24, 2024
Due Date: November 24, 2024
Service Location: Japan Osaka
Bill To
Patient Name: Tanaka Hiroshi
Address: 3-12-4 Namba, Chuo-ku, Osaka, 542-0076, Japan
Phone: +81-90-1234-5678
Email: [email protected]
National Health Insurance ID: NH-OSK-882910
Service Details
Attending Ophthalmologist: Dr. Kenji Sato, M.D., Ph.D.
Department: Retinal Surgery & Laser Therapy
Date of Service: October 20, 2024
Diagnosis Code (ICD-10): H35.30 (Age-related macular degeneration)
Procedure Code: J-OPH-2024-LASER
| # | Description of Ophthalmology Services | Quantity | Unit Price (JPY) | Total (JPY) |
|---|---|---|---|---|
| 1 |
Comprehensive Ophthalmological Examination Initial consultation and diagnostic assessment performed by a licensed Ophthalmologist in Japan Osaka. Includes visual acuity testing, refraction, and slit-lamp biomicroscopy. |
1 | 15,000 | 15,000 |
| 2 |
Optical Coherence Tomography (OCT) Advanced non-invasive imaging of the retina to detect macular degeneration. Conducted at the Osaka Advanced Ophthalmology Center using state-of-the-art equipment. |
1 | 25,000 | 25,000 |
| 3 |
Laser Photocoagulation Therapy Therapeutic laser treatment administered by the Ophthalmologist to seal leaking blood vessels in the retina. Procedure performed under local anesthesia. |
1 | 85,000 | 85,000 |
| 4 |
Post-Operative Medication Prescription for anti-inflammatory eye drops and antibiotics. Dispensed at the clinic pharmacy in Japan Osaka. |
2 | 3,500 | 7,000 |
| 5 |
Follow-up Consultation Scheduled review appointment with the Ophthalmologist to monitor healing progress and adjust treatment plan if necessary. |
1 | 10,000 | 10,000 |
Important Notes & Payment Instructions
This Invoice is issued by the Osaka Advanced Ophthalmology Center, a leading medical facility specializing in eye care in Japan Osaka. All services listed above were performed by qualified Ophthalmologists licensed under the Japanese Medical Practitioners Act.
Payment Methods:
- Bank Transfer: Mizuho Bank, Umeda Branch, Account No: 1234567890, Account Name: Osaka Advanced Ophthalmology Center.
- Credit Card: Visa, Mastercard, JCB accepted at the clinic reception.
- Cash: Japanese Yen only, accepted at the clinic in Japan Osaka.
Please include the Invoice Number (INV-2024-10-045) as the reference for all payments. If you have any questions regarding this Invoice or the services provided by our Ophthalmologist team, please contact our billing department at +81-6-6345-8899 or email [email protected].
Insurance Information:
This Invoice reflects an estimated deduction based on the National Health Insurance system in Japan. Final reimbursement amounts may vary depending on your specific insurance plan. Please submit this document to your insurance provider for processing. The Osaka Advanced Ophthalmology Center is registered with all major health insurance providers in Japan Osaka.
Confidentiality:
This Invoice contains confidential medical and financial information. It is intended solely for the use of the individual or entity named above. If you are not the intended recipient, please notify us immediately and destroy this document.
Authorized Signature:
Dr. Kenji Sato, M.D., Ph.D.
Chief Ophthalmologist
Osaka Advanced Ophthalmology Center
Patient Acknowledgment:
Tanaka Hiroshi
Date: _______________
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