Invoice Radiologist in Italy Rome –Free Word Template Download with AI
Specialized Diagnostic Imaging Center
Via dei Coronari, 45
00186 Rome, Italy
P.IVA / C.F.: IT01234567890
REA: RM-1234567
Email: [email protected]
Phone: +39 06 1234 5678
Invoice Number: 2023/RAD/1045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Service Period: October 2023
BILL TO:
ASL Roma 1 - Azienda Sanitaria Locale
Dipartimento di Diagnostica per Immagini
Viale del Policlinico, 155
00161 Rome, Italy
Codice Fiscale: 00001234567
Attn: Procurement Department
| Item | Description of Radiological Services | Quantity | Unit Price (€) | Total (€) |
|---|---|---|---|---|
| 1 |
Magnetic Resonance Imaging (MRI) - Brain with Contrast Comprehensive neuro-radiological assessment performed by a senior specialist radiologist. Includes pre-scan patient evaluation, administration of gadolinium-based contrast media, high-resolution 3T scanning, and detailed interpretation of images for pathological anomalies. Report issued in accordance with Italian radiological standards. |
12 | 250.00 | 3,000.00 |
| 2 |
Computed Tomography (CT) - Chest & Abdomen Multi-slice CT scan for oncological staging and trauma assessment. Service includes radiologist supervision, image reconstruction, and urgent reporting within 24 hours. Performed at our Rome central facility using state-of-the-art Siemens equipment. |
8 | 180.00 | 1,440.00 |
| 3 |
Echocardiography (Cardiac Ultrasound) Transthoracic echocardiogram performed by a cardiologist-radiologist specialist. Includes assessment of valvular function, ejection fraction, and structural integrity. Digital report provided to referring physician. |
15 | 120.00 | 1,800.00 |
| 4 |
Mammography with Tomosynthesis Advanced breast cancer screening and diagnostic procedure. Includes BI-RADS classification by a certified breast imaging radiologist. Complies with Italian Ministry of Health screening protocols. |
20 | 95.00 | 1,900.00 |
| 5 |
Urgent Radiological Consultation & Second Opinion Expert review of complex imaging cases by a board-certified radiologist. Includes tele-radiology consultation with referring doctors in Rome hospitals. |
5 | 150.00 | 750.00 |
Payment Instructions & Terms
Payment is due within 30 days from the date of this invoice. Please make payment via bank transfer to the following account:
Bank: Banca Intesa Sanpaolo
IBAN: IT60 X030 6909 6061 0000 0012 345
BIC/SWIFT: BCITITMM
Reference: Invoice 2023/RAD/1045
For any discrepancies regarding the services rendered by our radiologists, please contact our billing department within 7 days of receipt.
Legal & Regulatory Compliance
This invoice is issued in accordance with the Italian Civil Code and current fiscal regulations governing medical services in Italy. Radiologia Capitolina S.r.l. is a registered healthcare provider operating in Rome, Italy, fully compliant with the privacy laws (GDPR and Italian D.Lgs. 196/2003) regarding patient data protection. All radiological examinations listed herein were performed by qualified medical professionals holding valid registration with the Italian Medical Council (Ordine dei Medici Chirurghi e Odontoiatri). The prices listed are exclusive of any third-party insurance reimbursements unless otherwise agreed upon in a separate contract. This document serves as the official fiscal receipt for the diagnostic imaging services provided during the specified period.
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