Invoice Ophthalmologist in Kenya Nairobi –Free Word Template Download with AI

BILL TO:

Mr. James Kamau

Unit 12B, The Mirage Apartments

Kilimani, Nairobi, Kenya

Phone: +254 712 345 678

Email: [email protected]

INSURANCE / REFERRAL DETAILS:

Provider: Jubilee Health Insurance

Policy Number: JHI-99887766

Group ID: CORP-NAIROBI-01

Referring Doctor: Dr. A. Omondi (GP)

#	Description of Ophthalmological Services	Quantity	Unit Price (KES)	Total (KES)
1	Comprehensive Ophthalmic Examination Initial consultation with the Ophthalmologist in Nairobi. Includes detailed history taking, visual acuity testing, slit-lamp biomicroscopy, and intraocular pressure measurement (Tonometry). Essential for diagnosing ocular conditions prevalent in the region.	1	4,500.00	4,500.00
2	Dilated Fundus Examination Pharmacological dilation of the pupil to allow for a thorough inspection of the retina, optic nerve, and macula. Critical for early detection of diabetic retinopathy and glaucoma, common concerns for patients in Kenya.	1	2,500.00	2,500.00
3	Optical Coherence Tomography (OCT) Advanced non-invasive imaging test that uses light waves to take cross-section pictures of your retina. This state-of-the-art technology available at our Nairobi clinic helps in precise diagnosis of macular degeneration.	1	6,000.00	6,000.00
4	Prescription Eyewear Dispensing High-index anti-reflective lenses with UV protection, fitted into durable frames. Selected based on the specific refractive error diagnosed during the ophthalmologist consultation.	1	12,000.00	12,000.00
5	Therapeutic Eye Drops (Prescription) Course of antibiotic and anti-inflammatory drops prescribed post-examination to manage mild conjunctival irritation. Medication sourced from licensed Nairobi pharmaceutical suppliers.	2	850.00	1,700.00
6	Follow-up Consultation Fee Scheduled review appointment with the Ophthalmologist to assess healing progress and adjust treatment plan if necessary. Ensures continuity of care within the Nairobi healthcare system.	1	2,000.00	2,000.00

Subtotal: KES 28,700.00 VAT (16%): KES 4,592.00 Insurance Coverage (Est.): - KES 20,000.00 AMOUNT DUE: KES 13,292.00

PAYMENT INSTRUCTIONS

Please remit payment within 14 days of the invoice date. We accept various payment methods common in Kenya:

M-Pesa Paybill: 522522 (Account: INV-0892)
Bank Transfer: Equity Bank, Nairobi Branch
Account Name: Nairobi Vision Care Specialists Ltd
Account Number: 0123456789
Cheque: Payable to "Nairobi Vision Care Specialists"

Note: For insurance claims, please submit this invoice along with the medical report to your provider.

TERMS AND CONDITIONS

1. This invoice is issued in accordance with the laws of Kenya and the regulations set by the Medical Practitioners and Dentists Council (MPDC).

2. All services rendered by our Ophthalmologist are subject to professional standards of care.

3. Late payments may incur a penalty interest of 2% per month.

4. Please retain this document for your personal medical and financial records.

5. If you have any questions regarding this invoice or the services provided at our Nairobi facility, please contact our billing department immediately.

⬇️ Download as DOCX Edit online as DOCX

Create your own Word template with our GoGPT AI prompt:

GoGPT