Invoice Radiologist in Netherlands Amsterdam –Free Word Template Download with AI
Keizersgracht 123
1015 CJ Amsterdam
Netherlands
Phone: +31 20 123 4567
Email: [email protected]
KVK: 12345678 | BTW: NL123456789B01
Invoice Number: INV-2023-0456
Date: October 15, 2023
Due Date: November 15, 2023
Payment Terms: Net 30
Billed To:
St. Lucas Andreas Hospital
Jan Tooropstraat 160
1074 AD Amsterdam
Netherlands
Attn: Medical Billing Department
Contact: Dr. J. van der Berg
| Service Description | Quantity | Unit Price (EUR) | Subtotal (EUR) | VAT (21%) |
|---|---|---|---|---|
|
Diagnostic MRI Scan - Brain Performed by Dr. A. de Vries, Radiologist Date: October 10, 2023 Patient ID: P-78901 Includes detailed imaging analysis and report |
1 | €450.00 | €450.00 | €94.50 |
|
CT Scan - Chest with Contrast Performed by Dr. M. Jansen, Radiologist Date: October 11, 2023 Patient ID: P-78902 Includes contrast administration and interpretation |
1 | €380.00 | €380.00 | €79.80 |
|
Ultrasound - Abdominal Performed by Dr. S. Bakker, Radiologist Date: October 12, 2023 Patient ID: P-78903 Real-time imaging and diagnostic report |
1 | €220.00 | €220.00 | €46.20 |
|
Mammography Screening Performed by Dr. L. Visser, Radiologist Date: October 13, 2023 Patient ID: P-78904 Bilateral screening with BI-RADS assessment |
1 | €180.00 | €180.00 | €37.80 |
|
Interventional Radiology Procedure Performed by Dr. R. van Dijk, Radiologist Date: October 14, 2023 Patient ID: P-78905 Image-guided biopsy with pathology sample collection |
1 | €650.00 | €650.00 | €136.50 |
|
Consultation - Complex Case Review Performed by Dr. A. de Vries, Senior Radiologist Date: October 14, 2023 Patient ID: P-78906 Multidisciplinary case discussion and second opinion |
1 | €300.00 | €300.00 | €63.00 |
Subtotal: €2,180.00
VAT (21%): €457.80
Total Amount Due: €2,637.80
Payment Instructions:
Please make payment via bank transfer to the following account:
Bank: ING Bank N.V.
Account Name: Amsterdam Radiology Center B.V.
IBAN: NL91 INGB 0001 2345 67
BIC/SWIFT: INGBNL2A
Reference: INV-2023-0456
Payments should be made within 30 days of the invoice date. Late payments may incur a statutory interest rate of 8% per annum in accordance with Dutch law.
Important Notes:
This invoice is issued in accordance with the Dutch Tax Administration requirements and the regulations governing medical services in the Netherlands. All radiological services were performed by certified radiologists licensed to practice in Amsterdam and throughout the Netherlands.
The Amsterdam Radiology Center adheres to the highest standards of medical imaging and diagnostic radiology. Our team of radiologists utilizes state-of-the-art equipment and follows international guidelines for image acquisition and interpretation.
For any questions regarding this invoice or the services provided, please contact our billing department at [email protected] or call +31 20 123 4567 during business hours (Monday to Friday, 9:00 AM to 5:00 PM CET).
Thank you for your business and for trusting Amsterdam Radiology Center with your diagnostic imaging needs. We are committed to providing exceptional radiological services to healthcare providers and patients throughout Amsterdam and the greater Netherlands region.
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