Invoice Radiologist in China Shanghai –Free Word Template Download with AI
Registered Medical Imaging & Diagnostic Center
Address: No. 1288 Century Avenue, Pudong New Area, Shanghai, China
Unified Social Credit Code: 91310115MA1K3X7Y2P
Tax Registration Number: 310115002938475
Contact: +86 21 5888 9999 | Email: [email protected]
Bill To (Client)
Shanghai International Medical Insurance Co., Ltd.
Attn: Claims Processing Department
Address: Floor 45, Shanghai World Financial Center
Pudong District, Shanghai, China, 200120
Tax ID: 91310115MA1K998877
Service Provider (Radiologist)
Dr. Li Wei, MD, PhD
Senior Consultant Radiologist
License No: 310115-2018-RAD-004
Specialization: Neuroradiology & Advanced MRI Interpretation
Affiliation: Shanghai Precision Radiology Group
| # | Description of Radiological Services | Quantity | Unit Price (CNY) | Total (CNY) |
|---|---|---|---|---|
| 1 |
Advanced MRI Brain Interpretation Comprehensive diagnostic review of 3T MRI scans including diffusion-weighted imaging (DWI) and perfusion analysis. Performed by Senior Radiologist Dr. Li Wei in accordance with Shanghai Health Commission standards. |
1 | 2,500.00 | 2,500.00 |
| 2 |
CT Thorax with Contrast Analysis Detailed radiological assessment of chest CT scans for pulmonary nodule characterization. Includes volumetric analysis and comparison with prior imaging studies. |
1 | 1,800.00 | 1,800.00 |
| 3 |
Urgent Teleradiology Consultation Emergency remote interpretation of trauma series X-rays and head CT for a patient at a partner clinic in Shanghai. Service rendered within 30 minutes of request. |
1 | 1,200.00 | 1,200.00 |
| 4 |
Second Opinion Report Generation Formal written radiological second opinion regarding complex oncological imaging findings. Includes detailed PDF report with annotated images for the referring physician. |
1 | 1,500.00 | 1,500.00 |
| 5 |
Quality Assurance & Protocol Review Monthly review of imaging protocols and image quality metrics for the Shanghai facility to ensure compliance with national radiological safety regulations. |
1 | 3,000.00 | 3,000.00 |
Amount in words: Ten Thousand Six Hundred Chinese Yuan Renminbi Only.
Payment Instructions & Terms
Please remit payment via bank transfer to the following account within 30 days of the invoice date. Late payments may incur a penalty interest rate of 0.05% per day as per standard commercial practices in Shanghai.
Bank Name: Bank of China, Shanghai Pudong Branch
Account Name: Shanghai Precision Radiology Group Co., Ltd.
Account Number: 4528 9900 1234 5678
SWIFT Code: BKCHCNBJ300
Currency: CNY (Chinese Yuan)
Important Note: This invoice represents professional services rendered by a licensed Radiologist in China Shanghai. All diagnostic interpretations are confidential and protected under the Personal Information Protection Law (PIPL) of the People's Republic of China. Please reference the Invoice Number (INV-SH-2023-10-045) in all correspondence regarding this payment.
Authorized Signature (Provider)
Dr. Li WeiSenior Radiologist
Received By (Client)
________________________Date: ________________ ⬇️ Download as DOCX Edit online as DOCX
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