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  • Deepika Patel Podiatrist: Statement

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    Tauriq Safodien
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    This document is a tax invoice from Deepika Patel Podiatrist for patient H Mohamed. It details a podiatry consultation that took place on March 16, 2021, including general podiatric care, infection control, sterile surgical blades, and a consultation. The total for the services was R630, which was paid in full by the patient via debit/credit card on the date of service. Banking details for Deepika R Patel are provided at the bottom.

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    Statement_20210316T112749

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    This document is a tax invoice from Deepika Patel Podiatrist for patient H Mohamed. It details a podiatry consultation that took place on March 16, 2021, including general podiatric care, infection control, sterile surgical blades, and a consultation. The total for the services was R630, which was paid in full by the patient via debit/credit card on the date of service. Banking details for Deepika R Patel are provided at the bottom.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    41 views2 pages

    Deepika Patel Podiatrist: Statement

    Uploaded by

    Tauriq Safodien
    This document is a tax invoice from Deepika Patel Podiatrist for patient H Mohamed. It details a podiatry consultation that took place on March 16, 2021, including general podiatric care, infection control, sterile surgical blades, and a consultation. The total for the services was R630, which was paid in full by the patient via debit/credit card on the date of service. Banking details for Deepika R Patel are provided at the bottom.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Deepika Patel Podiatrist Statement

    15 Brommersvlei Road VAT No:


    Constantia BHF Practice no: 6803342
    Cape Town 7806 Tel no: +27217945789
    South Africa Fax no:
    Email: podiatrist3@gmail.com

    H Mohamed Funder Type: Private Patient Date: 16-Mar-2021


    16 6th Street Payor: Mohamed, Hajira Customer ID: P000451
    Kensington
    Cape Town Statement Type: Full
    7405
    ID / DoB: 6410100186084

    H Mohamed - ID / DoB:
    P000451:
    6410100186084

    Date Description Diagnosis Nappi / Modifier Reference Quantity Note Discount Amount Funder Patient Total Due

    16-Mar-2021 Tax Invoice 007517 0.00 630.00 0.00 0.00 0.00


    11:00 - 11:30
    68011: General podiatric care (30
    L60.0 1 0.00 170.00
    minutes) including the follo...
    68040: Infection control, per patient L60.0 1 0.00 20.00
    68201: Sterile Surgical Blades
    L60.0 1 0.00 20.00
    (maximum of 2 per patient)
    68303: Consultation (initial or follow
    L60.0 1 0.00 420.00
    up) 21-30 minutes
    Place of Service: Integration House

    Treating Provider: Basha, Jameela

    16-Mar-2021 Patient Payment Received - 0.00 (630.00) 0.00 0.00 0.00


    Debit/Credit Card

    0.00 0.00 0.00 0.00 0.00

    Created with EZMed by Galiema Heske on 16-Mar-2021 at 11:27 Page: 1 of 2


    Deepika Patel Podiatrist Statement
    15 Brommersvlei Road VAT No:
    Constantia BHF Practice no: 6803342
    Cape Town 7806 Tel no: +27217945789
    South Africa Fax no:
    Email: podiatrist3@gmail.com

    BANKING DETAILS 120 DAYS + 90 DAYS 60 DAYS 30 DAYS CURRENT TOTAL


    Account Name: Deepika R Patel FUNDER 0.00 0.00 0.00 0.00 0.00 0.00
    Bank Name: First National Bank
    PATIENT 0.00 0.00 0.00 0.00 0.00 0.00
    Branch: 250737 - Lenasia
    TOTAL DUE 0.00 0.00 0.00 0.00 0.00 0.00
    Account Number: 62020374625
    Account Type: Cheque account
    Payment Ref No: Use patient (P) code as reference
    Thank you for your support!

    Created with EZMed by Galiema Heske on 16-Mar-2021 at 11:27 Page: 2 of 2

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