Invoice Radiologist in Nigeria Abuja –Free Word Template Download with AI
Lead Radiologist: Dr. Emeka Okonkwo, FRCR
Plot 142, Aguiyi Ironsi Street, Maitama
Abuja, FCT, Nigeria
Tel: +234 9 460 1234 | Email: [email protected]
TIN: 12345678-0001
Invoice #: INV-2023-ABJ-0892
Date: October 24, 2023
Due Date: November 07, 2023
Reference: MRI-Scan-Ref-445
Bill To:
Client Name: Mrs. Amina Yusuf
Address: 15, Gana Street, Wuse II, Abuja, Nigeria
Phone: +234 803 555 1234
Insurance Provider: Leadway Assurance (Policy #LW-998877)
This document serves as an official Invoice for professional medical imaging services rendered by a certified Radiologist at our facility located in Nigeria Abuja. The services detailed below were performed in accordance with the highest standards of diagnostic radiology, utilizing state-of-the-art equipment to ensure accurate interpretation of medical images. As a leading provider of radiological services in the Federal Capital Territory, we are committed to delivering precise diagnostic reports to support your healthcare journey.
| # | Description of Radiological Services | Quantity | Unit Price (NGN) | Total (NGN) |
|---|---|---|---|---|
| 1 |
Magnetic Resonance Imaging (MRI) - Brain with Contrast Performed by Senior Radiologist. Includes intravenous contrast administration and detailed interpretation report. |
1 | 180,000.00 | 180,000.00 |
| 2 |
Radiologist Professional Fee Fee for the specialized interpretation of MRI scans by a Consultant Radiologist registered with the Medical and Dental Council of Nigeria (MDCN). |
1 | 45,000.00 | 45,000.00 |
| 3 |
Computed Tomography (CT) Scan - Chest High-resolution CT scan of the thorax to evaluate pulmonary structures. Includes digital image storage. |
1 | 95,000.00 | 95,000.00 |
| 4 |
Urgent Report Delivery Expedited processing and delivery of the radiologist's written report to the referring physician within 4 hours. |
1 | 15,000.00 | 15,000.00 |
| 5 |
Digital Image Copy (CD/USB) Physical copy of DICOM images for second opinion or transfer to another facility in Abuja. |
1 | 5,000.00 | 5,000.00 |
| Subtotal: | ₦ 340,000.00 |
| VAT (7.5%): | ₦ 25,500.00 |
| Grand Total: | ₦ 365,500.00 |
Payment Instructions
Please make payment within 14 days of the invoice date. Payments can be made via bank transfer to our account in Nigeria Abuja.
Bank Name: Zenith Bank Plc
Account Name: Abuja Advanced Radiology Centre Ltd
Account Number: 1012345678
Branch: Central Business District, Abuja
Kindly use the Invoice Number (INV-2023-ABJ-0892) as the payment reference. Upon confirmation of payment, a receipt will be issued.
Terms and Conditions
- All services rendered are subject to the professional standards of the Radiological Society of Nigeria.
- This Invoice is valid for 30 days from the date of issue.
- Late payments may incur a penalty interest of 2% per month on the outstanding balance.
- The Radiologist's report is confidential and intended solely for the use of the patient and their treating medical team.
- In the event of a dispute regarding the charges, please contact our billing department in Abuja within 7 days.
- Insurance claims should be submitted directly by the patient or their representative to the respective HMO.
Authorized Signature
Dr. Emeka Okonkwo
Lead Radiologist
Received By
__________________________
Date: ____________________
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