Invoice Radiologist in Australia Melbourne –Free Word Template Download with AI
Level 3, 123 Collins Street
Melbourne VIC 3000
Australia
Phone: +61 3 9876 5432
Email: [email protected]
ABN: 12 345 678 901
Provider Number: 9876543210
Invoice Number: INV-2024-0567
Date: 15 May 2024
Due Date: 15 June 2024
Bill To:
Dr. Sarah Johnson
Private Practice
456 Swanston Street
Melbourne VIC 3000
Australia
Medicare Provider Number: 1234567890
Contact: +61 3 1234 5678
Patient Information:
Patient Name: John Smith
Date of Birth: 12 March 1975
Medicare Number: 1234 567890
Service Date: 10 May 2024
Referring Practitioner: Dr. Sarah Johnson
Services Rendered:
| Item Number | Description | Quantity | Unit Price (AUD) | Total (AUD) |
|---|---|---|---|---|
| 37010 | Magnetic Resonance Imaging (MRI) of the Brain with and without contrast medium | 1 | $450.00 | $450.00 |
| 37015 | Interpretation and reporting of MRI Brain by a specialist Radiologist | 1 | $250.00 | $250.00 |
| 37020 | Contrast medium administration and monitoring | 1 | $150.00 | $150.00 |
| 37025 | Urgent reporting fee (within 24 hours) | 1 | $100.00 | $100.00 |
| Subtotal | $950.00 | |||
| GST (10%) | $95.00 | |||
| Total Amount Due | $1,045.00 | |||
Payment Instructions:
Please make payment within 30 days of the invoice date. Payments can be made via bank transfer to the following account:
Bank: Commonwealth Bank of Australia
Account Name: Melbourne Advanced Radiology Centre
BSB: 062-000
Account Number: 12345678
Reference: INV-2024-0567
For any queries regarding this invoice, please contact our billing department at [email protected] or call +61 3 9876 5432.
Important Information:
This invoice is issued in accordance with the Australian Taxation Office (ATO) requirements and includes Goods and Services Tax (GST) where applicable. The services provided by our Radiologist are covered under the Medicare Benefits Schedule (MBS) where eligible. Please ensure that all patient details are accurate to facilitate proper Medicare rebates.
Melbourne Advanced Radiology Centre is committed to providing high-quality diagnostic imaging services in Melbourne, Australia. Our team of experienced Radiologists ensures accurate and timely reporting to support your clinical decision-making.
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