Invoice Radiologist in Brazil São Paulo –Free Word Template Download with AI
Specialized Radiology Services
Av. Paulista, 1000, Bela Vista
São Paulo - SP, 01310-100, Brazil
CNPJ: 12.345.678/0001-90
CREMESP: 123456
Email: [email protected]
Phone: +55 (11) 3456-7890
Invoice #: INV-2023-SP-8921
Date: October 24, 2023
Due Date: November 07, 2023
Status: Pending Payment
Bill To:Dr. Ricardo Mendes - Private Practice
Rua Oscar Freire, 500, Jardins
São Paulo - SP, 01426-001, Brazil
CPF: 111.222.333-44
Email: [email protected]
Description of Radiological Services Rendered| Item | Description / Procedure | Qty | Unit Price (BRL) | Total (BRL) |
|---|---|---|---|---|
| 1 |
Magnetic Resonance Imaging (MRI) - Brain with Contrast Performed by: Dr. Ana Silva, Lead Radiologist. Detailed interpretation of cranial structures including neurovascular assessment. Report issued in accordance with Brazilian Society of Radiology standards. |
1 | R$ 1.200,00 | R$ 1.200,00 |
| 2 |
Computed Tomography (CT) - Chest & Abdomen Performed by: Dr. Carlos Oliveira, Senior Radiologist. High-resolution scan for oncological staging. Includes 3D reconstruction and comprehensive diagnostic report. |
1 | R$ 950,00 | R$ 950,00 |
| 3 |
Echocardiography with Doppler Performed by: Dr. Ana Silva, Lead Radiologist. Assessment of cardiac function and valvular integrity. Standard protocol followed for São Paulo regional health guidelines. |
1 | R$ 600,00 | R$ 600,00 |
| 4 |
Mammography with Tomosynthesis Performed by: Dr. Julia Santos, Breast Imaging Specialist. Screening and diagnostic evaluation. BI-RADS classification included in final report. |
1 | R$ 750,00 | R$ 750,00 |
| 5 |
Urgent Radiological Consultation Performed by: Dr. Carlos Oliveira, Senior Radiologist. Second opinion on complex abdominal CT findings. Includes telemedicine consultation and detailed written summary. |
1 | R$ 400,00 | R$ 400,00 |
Please remit payment within 15 days of the invoice date to avoid late fees. Payments can be made via bank transfer (TED/DOC) or PIX to the following account:
- Bank: Banco do Brasil
- Agency: 1234-5
- Account: 98765-4 (Checking)
- Account Holder: Paulista Advanced Imaging Center Ltda.
- PIX Key: [email protected]
Note: Please include the Invoice Number (INV-2023-SP-8921) as the payment reference.
Terms and Conditions1. Late Payment: A penalty of 2% plus interest of 1% per month will be applied to overdue amounts, in accordance with Brazilian commercial law.
2. Validity: This invoice is valid for 30 days from the date of issue. After this period, a new invoice may be required.
3. Medical Records: All radiological images and reports are stored securely in our PACS system for a minimum of 5 years, as required by Brazilian health regulations.
4. Confidentiality: All patient information is handled in strict confidence, complying with LGPD (Lei Geral de Proteção de Dados) and medical ethics codes.
5. Disputes: Any discrepancies regarding this invoice must be reported within 10 business days of receipt.
This document serves as a formal invoice for professional radiological services provided in São Paulo, Brazil. The services were performed by licensed radiologists registered with the Regional Council of Medicine of São Paulo (CREMESP). The pricing reflects current market rates for specialized imaging in the metropolitan area of São Paulo. This invoice is issued in compliance with Brazilian tax laws and municipal regulations of the City of São Paulo. For any questions regarding this invoice or the services provided, please contact our billing department at the address listed above. Thank you for choosing Paulista Advanced Imaging Center for your diagnostic imaging needs.
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