Invoice Radiologist in Spain Madrid –Free Word Template Download with AI
Calle de Alcalá, 123, 28009 Madrid, Spain
Phone: +34 91 123 45 67 | Email: [email protected]
NIF: B-12345678 | Medical License: M-28-98765
Member of the Madrid College of Radiologists
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Service Period: October 2023
Service Provider (Radiologist)
Dr. Elena García López
Senior Consultant Radiologist
Specialization: Neuroradiology & MRI
Colegio Oficial de Radiólogos de Madrid
Professional ID: 28-5543
Billed To
Clínica San Carlos
Attn: Administrative Department
Calle de O'Donnell, 1, 28009 Madrid, Spain
NIF: A-87654321
Patient Reference: P-2023-8892
| # | Description of Radiological Services | Date | Qty | Unit Price (€) | Total (€) |
|---|---|---|---|---|---|
| 1 |
Magnetic Resonance Imaging (MRI) - Brain Comprehensive neuroradiological interpretation including diffusion-weighted imaging (DWI) and angiography (MRA). Performed at Madrid Advanced Radiology Center. |
2023-10-02 | 1 | 185.00 | 185.00 |
| 2 |
Computed Tomography (CT) Scan - Chest High-resolution CT scan with contrast media administration. Detailed radiological report provided for oncological assessment. |
2023-10-05 | 1 | 145.00 | 145.00 |
| 3 |
Ultrasound Examination - Abdomen Complete abdominal ultrasound including liver, gallbladder, pancreas, and kidneys. Real-time imaging analysis by senior radiologist. |
2023-10-10 | 1 | 95.00 | 95.00 |
| 4 |
Mammography Screening Bilateral digital mammography with tomosynthesis. Interpretation according to BI-RADS classification standards. |
2023-10-12 | 1 | 110.00 | 110.00 |
| 5 |
Interventional Radiology Procedure Image-guided biopsy of liver lesion using ultrasound guidance. Includes procedural sedation monitoring and post-procedure care assessment. |
2023-10-15 | 1 | 320.00 | 320.00 |
| 6 |
Emergency Radiological Consultation Urgent interpretation of trauma series X-rays (spine and pelvis) during night shift at Madrid hospital facility. |
2023-10-18 | 1 | 150.00 | 150.00 |
| 7 |
Pediatric Radiology Assessment Specialized ultrasound examination for pediatric patient. Includes detailed report for pediatrician follow-up. |
2023-10-20 | 1 | 105.00 | 105.00 |
| 8 |
Second Opinion Radiological Review Comprehensive review of previous MRI scans from external facility. Detailed comparative analysis report provided. |
2023-10-22 | 1 | 130.00 | 130.00 |
| Subtotal: | 1,240.00 € |
| IVA (21% - Spain Standard Rate): | 260.40 € |
| IRPF Withholding (15% - Professional Services): | -186.00 € |
| NET AMOUNT DUE: | 1,314.40 € |
Payment Instructions
Please remit payment within 30 days of the invoice date. Late payments may incur a 1.5% monthly interest charge as per Spanish commercial law.
Bank Transfer Details:
Bank: Banco Santander, Madrid Branch
IBAN: ES91 2100 0418 4502 0005 1332
BIC/SWIFT: BSCHESMM
Reference: INV-2023-10-045
Professional Notes
All radiological services listed on this invoice were performed in accordance with the clinical practice guidelines established by the Spanish Society of Radiology and Imaging (SERAM). The radiologist responsible for these interpretations is fully licensed and registered with the Madrid College of Radiologists.
Digital copies of all imaging studies and radiological reports have been securely transmitted to the referring physician via the Madrid Health Network (Red de Salud Madrid) encrypted portal. Physical media (CD/DVD) can be provided upon request at an additional cost.
This invoice represents professional fees for radiological interpretation and procedural services only. Equipment usage fees, facility charges, and contrast media costs are billed separately by Madrid Advanced Radiology Center.
Legal Notice: This invoice is issued in compliance with Spanish tax legislation (Ley 58/2003, General Tax Law) and the regulations governing medical professional services in the Community of Madrid. All prices are expressed in Euros (€), the official currency of Spain. The radiologist providing these services maintains professional liability insurance through Mutua Madrileña, policy number MED-2023-778899. Patient data processed in connection with these services is handled in accordance with the General Data Protection Regulation (GDPR) and Spanish Organic Law 3/2018 on Personal Data Protection. Any disputes arising from this invoice shall be subject to the jurisdiction of the courts of Madrid, Spain. This document serves as official proof of payment for tax purposes and should be retained for a minimum of four years as required by Spanish fiscal authorities.
Authorized by:
Dr. Elena García López
Senior Consultant Radiologist
Madrid Advanced Radiology Center
Received by:
___________________________
Date: _____________________
Clínica San Carlos
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