Invoice Radiologist in South Africa Johannesburg –Free Word Template Download with AI
123 Rivonia Road, Sandton, Johannesburg, 2196
South Africa
Tel: +27 11 555 1234
Email: [email protected]
Reg No: 2015/123456/07
VAT No: 4560123456
Invoice Number: INV-2024-0892
Date Issued: 15 October 2024
Due Date: 15 November 2024
Payment Terms: Net 30 Days
Billed To:
MediCare Health Insurance Ltd.
456 Nelson Mandela Square
Sandton, Johannesburg, 2196
South Africa
Attn: Claims Department
Reference: Patient ID #P-789456
| Item Description | Service Date | Quantity | Unit Price (ZAR) | Total (ZAR) |
|---|---|---|---|---|
|
Consultation with Specialist Radiologist Comprehensive review of imaging results and clinical correlation by Dr. N. Mokoena, FCRad(SA). Includes detailed report and discussion with referring physician. |
10 Oct 2024 | 1 | 1,200.00 | 1,200.00 |
|
MRI Brain with Contrast High-resolution magnetic resonance imaging of the brain with gadolinium contrast. Performed on 3T Siemens scanner. Interpretation by senior radiologist. |
10 Oct 2024 | 1 | 4,500.00 | 4,500.00 |
|
CT Chest with Contrast Computed tomography scan of the chest with intravenous contrast. Includes lung window and mediastinal window reconstructions. |
11 Oct 2024 | 1 | 3,200.00 | 3,200.00 |
|
Ultrasound Abdomen Full Complete abdominal ultrasound including liver, gallbladder, pancreas, spleen, kidneys, and aorta. Performed by registered sonographer, reported by radiologist. |
12 Oct 2024 | 1 | 1,800.00 | 1,800.00 |
|
Mammography Bilateral with Tomosynthesis Digital breast tomosynthesis (3D mammography) for enhanced detection. Includes BI-RADS assessment by breast imaging specialist radiologist. |
13 Oct 2024 | 1 | 2,100.00 | 2,100.00 |
|
Interventional Radiology Procedure Image-guided biopsy of liver lesion under ultrasound guidance. Includes local anaesthesia, specimen handling, and post-procedure monitoring. |
14 Oct 2024 | 1 | 5,500.00 | 5,500.00 |
|
Second Opinion Report Independent review of prior imaging studies by senior radiologist. Includes comparative analysis and updated diagnostic impression. |
14 Oct 2024 | 1 | 900.00 | 900.00 |
Subtotal: R 19,200.00
VAT (15%): R 2,880.00
Total Amount Due: R 22,080.00
Payment Instructions:
Please make payment via Electronic Funds Transfer (EFT) to the following bank account:
Bank: Standard Bank
Account Name: Sandton Advanced Radiology Centre (Pty) Ltd
Account Number: 123456789
Branch Code: 051001
Reference: INV-2024-0892
Payments received after the due date may be subject to a late fee of 1.5% per month on the outstanding balance, in accordance with South African credit practices.
Important Notes:
This invoice is issued in accordance with the National Health Act and the regulations governing radiological services in South Africa. All imaging procedures were performed by qualified medical professionals registered with the Health Professions Council of South Africa (HPCSA). Our radiologists are specialists in diagnostic and interventional radiology, providing services across Johannesburg and the greater Gauteng region.
All services rendered comply with the Medical Schemes Act and relevant tariff guidelines. If you have any questions regarding this invoice or require additional documentation, please contact our billing department at [email protected] or call +27 11 555 1234.
Thank you for choosing Sandton Advanced Radiology Centre for your diagnostic imaging needs in Johannesburg, South Africa. We are committed to providing accurate, timely, and compassionate radiological care.
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