Invoice Ophthalmologist in United Kingdom Manchester –Free Word Template Download with AI
Consultant Ophthalmologist Services
12 Deansgate Square, Spinningfields
Manchester, M3 4LQ
United Kingdom
Tel: +44 (0)161 555 0199
Email: [email protected]
VAT Registration No: GB 123 4567 89
GMC Registration No: 1234567
From
Dr. Eleanor Sterling, FRCS (Ophth)
Consultant Ophthalmologist
Manchester Vision Specialists
12 Deansgate Square
Manchester, M3 4LQ
United Kingdom
Bill To
Mr. James Davidson
45 Wilmslow Road
Didsbury, Manchester
M20 2RW
United Kingdom
NHS Number: 485 772 9910
Private Patient Account
| # | Description of Ophthalmological Services | Date of Service | Unit Price (GBP) | Total (GBP) |
|---|---|---|---|---|
| 1 |
Initial Comprehensive Ophthalmic Consultation Detailed history taking, visual acuity assessment, slit-lamp examination, and intraocular pressure measurement. Conducted at our Manchester clinic. |
15 Oct 2023 | £180.00 | £180.00 |
| 2 |
Optical Coherence Tomography (OCT) Scan High-resolution imaging of the retina and optic nerve head to assess macular health and glaucoma risk. |
15 Oct 2023 | £120.00 | £120.00 |
| 3 |
Visual Field Analysis (Perimetry) Automated perimetry to map peripheral vision and detect field defects associated with neurological or ocular conditions. |
15 Oct 2023 | £95.00 | £95.00 |
| 4 |
Follow-up Review and Management Plan Review of diagnostic results, discussion of diagnosis (Early Cataract Formation), and formulation of surgical management plan. |
22 Oct 2023 | £110.00 | £110.00 |
| 5 |
Pre-Operative Assessment Biometry for intraocular lens calculation, corneal topography, and final surgical clearance. |
23 Oct 2023 | £150.00 | £150.00 |
| 6 |
Administrative Fee Processing of medical records, correspondence with GP in Manchester, and insurance documentation. |
24 Oct 2023 | £45.00 | £45.00 |
| Subtotal | £695.00 |
| VAT (20%) | £139.00 |
| Total Due | £834.00 |
Payment Instructions & Terms
Bank Transfer Details:
Bank Name: Barclays Bank PLC
Account Name: Manchester Vision Specialists Ltd
Sort Code: 20-00-00
Account Number: 12345678
Reference: INV-2023-10-045
Terms and Conditions:
1. Payment is due within 30 days of the invoice date. Late payments may incur interest charges at 4% above the Bank of England base rate.
2. This invoice covers private ophthalmological services provided in Manchester, United Kingdom. It is not a claim form for the NHS.
3. If you have private medical insurance, please submit this invoice directly to your provider. We can provide additional clinical notes upon request.
4. All medical services are performed by a fully registered Consultant Ophthalmologist with the General Medical Council (GMC).
5. For any queries regarding this invoice, please contact our billing department at [email protected] or call +44 (0)161 555 0199.
Authorized By:
Dr. Eleanor Sterling
Consultant Ophthalmologist
Manchester Vision Specialists
Received By:
__________________________
Date: ______________________
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