Invoice Radiologist in Russia Moscow –Free Word Template Download with AI
12th Lesnaya Street, Building 4
Tverskoy District, Moscow, 125047
Russia
OGRN: 1197746000000 | INN/KPP: 7700000000 / 770001001
Email: [email protected] | Phone: +7 (495) 123-45-67
Invoice #: INV-2023-10-8842
Date: October 24, 2023
Due Date: November 24, 2023
Payment Terms: Net 30
Bill To (Client)St. George International Clinic
Attn: Procurement Department
15 Kutuzovsky Avenue
Moscow, 121248
Russia
Service Provider (Radiologist)Dr. Alexander Volkov, MD, PhD
Senior Consultant Radiologist
License No: LO-77-01-000000
Specialization: Neuroradiology & MRI
Member of the Russian Radiological Society
This document serves as a formal Invoice for professional medical imaging services rendered by the undersigned Radiologist. These services were conducted in accordance with the high standards of healthcare regulation enforced within Russia Moscow. The following charges reflect the diagnostic interpretation, technical consultation, and reporting fees associated with the procedures performed during the billing period.
| # | Description of Radiological Services | Quantity | Unit Price (RUB) | Total (RUB) |
|---|---|---|---|---|
| 1 |
MRI Brain with Contrast (Neuroradiology) Comprehensive interpretation of magnetic resonance imaging of the brain with gadolinium contrast. Detailed analysis of parenchymal structures, ventricular system, and vascular flow voids. Report generated in English and Russian for international patient compliance. |
15 | 4,500.00 | 67,500.00 |
| 2 |
CT Thorax (High Resolution) Diagnostic interpretation of computed tomography scans of the chest. Evaluation of lung parenchyma, mediastinum, and pleural spaces. Includes 3D reconstruction analysis for complex cases. |
20 | 3,800.00 | 76,000.00 |
| 3 |
Musculoskeletal MRI (Lumbar Spine) Detailed radiological assessment of the lumbar spine. Evaluation of intervertebral discs, spinal canal stenosis, and nerve root compression. Consultation notes included. |
10 | 4,200.00 | 42,000.00 |
| 4 |
Urgent Trauma Radiology Consultation Emergency interpretation of X-rays and CT scans for trauma patients. Immediate verbal reporting to the attending physician followed by written documentation within 2 hours. |
5 | 6,000.00 | 30,000.00 |
| 5 |
Mammography Screening & BI-RADS Assessment Diagnostic interpretation of bilateral mammograms. Classification of findings according to BI-RADS standards. Follow-up recommendations provided. |
25 | 2,500.00 | 62,500.00 |
| 6 |
Second Opinion Review (Complex Oncology) Retrospective review of prior imaging studies for oncology patients. Comparative analysis with current scans to assess treatment response. |
8 | 5,500.00 | 44,000.00 |
Please remit payment within 30 days of the invoice date. Payments should be made via bank transfer to the following account details located in Moscow, Russia:
Bank Name: Sberbank of Russia, Moscow Branch
Account Name: Moscow Advanced Radiology Center LLC
Account Number: 40702810000000000000
BIC/SWIFT: SABRRUMM
Correspondent Account: 30101810145250000974
Reference: Please use Invoice #INV-2023-10-8842 as the payment reference.
Terms, Conditions, and Regulatory Notes- Regulatory Compliance: All radiological services provided by the Radiologist listed on this Invoice have been performed in strict compliance with the Federal Law of the Russian Federation "On the Fundamentals of Protection of the Health of Citizens in the Russian Federation" and the sanitary norms established by Rospotrebnadzor for medical imaging facilities in Moscow.
- Professional Liability: The interpretations provided are based on the medical images available at the time of review. The Radiologist assumes professional responsibility for the diagnostic accuracy within the scope of standard medical practice in Russia.
- Late Payments: In accordance with the Civil Code of the Russian Federation, late payments will incur interest at the rate of the key rate of the Central Bank of Russia plus 3% per annum for each day of delay.
- Data Privacy: Patient data processed during the generation of these reports is handled in accordance with Federal Law No. 152-FZ "On Personal Data." All records are stored securely within the Moscow region.
- Disputes: Any disputes regarding this Invoice should be directed to the billing department of the Moscow Advanced Radiology Center within 14 days of receipt.
Thank you for your business. We are committed to providing the highest quality radiological diagnostics in Moscow, Russia.
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