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    Claim History Statement 3 Hi

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    narularaina870
    This document is a Medicare claims history for Raina Narula between September 10, 2020 and September 1, 2021. It lists various medical services provided by different doctors, including prenatal appointments, consultations, ultrasounds, and tests. The services were all bulk billed, so the total costs were covered by Medicare benefits and Raina did not have to pay anything out of pocket.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Claim History Statement 3 Hi

    Uploaded by

    narularaina870
    74 views3 pages
    This document is a Medicare claims history for Raina Narula between September 10, 2020 and September 1, 2021. It lists various medical services provided by different doctors, including prenatal appointments, consultations, ultrasounds, and tests. The services were all bulk billed, so the total costs were covered by Medicare benefits and Raina did not have to pay anything out of pocket.

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    Claim History Statement 3 hi

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    This document is a Medicare claims history for Raina Narula between September 10, 2020 and September 1, 2021. It lists various medical services provided by different doctors, including prenatal appointments, consultations, ultrasounds, and tests. The services were all bulk billed, so the total costs were covered by Medicare benefits and Raina did not have to pay anything out of pocket.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    74 views3 pages

    Claim History Statement 3 Hi

    Uploaded by

    narularaina870
    This document is a Medicare claims history for Raina Narula between September 10, 2020 and September 1, 2021. It lists various medical services provided by different doctors, including prenatal appointments, consultations, ultrasounds, and tests. The services were all bulk billed, so the total costs were covered by Medicare benefits and Raina did not have to pay anything out of pocket.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    MEDICARE CLAIMS HISTORY FOR RAINA NARULA BETWEEN 09/10/2020 AND 09/01/2021

    GPO Box 9822


    In your capital city
    Enquires
    132 011
    www.servicesaustralia.gov.au

    PATIENT'S NAME RAINA NARULA


    MEDICARE CARD NUMBER 6266046024
    INDIVIDUAL REFERENCE NUMBER 2
    Date of Birth 12/01/1983

    MEDICAL SERVICES

    Services provided by: DR JOHANNES CONRADIE


    Date of Item Brief Item Description Total Cost Benefit Paid by Cost to Payment Method Reason
    Service Number of Services Government Claimant Codes
    16/12/2020 74995 Bulk Bill Incentive (BBI) for item 73899, 73900, $3.40 $3.40 $0.00 Bulk Bill
    73928, 73930 or 73936.
    16/12/2020 73928 Initiation of a patient episode by collection of a $5.10 $5.10 $0.00 Bulk Bill
    specimen for 1 or more
    services
    16/12/2020 66750 Quantitation, in pregnancy, $33.80 $33.80 $0.00 Bulk Bill
    08/12/2020 74995 Bulk Bill Incentive (BBI) for item 73899, 73900, $3.40 $3.40 $0.00 Bulk Bill
    73928, 73930 or 73936.

    Page 1 of 3
    Services provided by: DR JOHANNES CONRADIE
    Date of Item Brief Item Description Total Cost Benefit Paid by Cost to Payment Method Reason
    Service Number of Services Government Claimant Codes
    08/12/2020 73928 Initiation of a patient episode by collection of a $5.10 $5.10 $0.00 Bulk Bill
    specimen for 1 or more
    services
    08/12/2020 69413 Microbiological serology $47.35 $47.35 $0.00 Bulk Bill
    08/12/2020 66596 Iron studies $27.70 $27.70 $0.00 Bulk Bill
    08/12/2020 65096 Blood group & examination of serum $34.85 $34.85 $0.00 Bulk Bill

    Total: $160.70 $160.70 $0.00


    Services provided by: DR HARSHI WEERASEKERA
    Date of Item Brief Item Description Total Cost Benefit Paid by Cost to Payment Method Reason
    Service Number of Services Government Claimant Codes
    18/12/2020 16500 Antenatal attendance. $41.35 $41.35 $0.00 Bulk Bill
    08/12/2020 00023 CONSULTATION AT CONSULTING ROOMS - $38.75 $38.75 $0.00 Bulk Bill
    LEVEL 'B'.

    Total: $80.10 $80.10 $0.00


    Services provided by: DR RADIKA KARUNARATHNE
    Date of Item Brief Item Description Total Cost Benefit Paid by Cost to Payment Method Reason
    Service Number of Services Government Claimant Codes
    16/12/2020 55700 PELVIS OR ABDOMEN, Pregnancy related or $57.90 $57.90 $0.00 Bulk Bill
    pregnancy complication, Ultrasound
    scan

    Total: $57.90 $57.90 $0.00


    Services provided by: DR MUHAMMAD KHAN
    Date of Item Brief Item Description Total Cost Benefit Paid by Cost to Payment Method Reason
    Service Number of Services Government Claimant Codes
    29/12/2020 00023 CONSULTATION AT CONSULTING ROOMS - $38.75 $38.75 $0.00 Bulk Bill
    LEVEL 'B'.

    Total: $38.75 $38.75 $0.00

    Page 2 of 3
    End Of Report

    Important information for you to know


    Claiming information may not appear on your Medicare Claims History Statement for up to 48 hours.
    This Medicare Claims History Statement cannot be used for the purpose of the Compensation Recovery Program or for claiming from Private Health Funds.
    Services Australia does not hold information about services that may have been provided to public patients at public hospitals.
    The accuracy of Medicare records depends on public patients being identified to Services Australia by their correct Medicare number and practitioners being
    identified by their correct Medicare provider number, on claims for payment.
    This Medicare Claims History Statement was printed by RAINA NARULA at 4:23 PM on 09 Jan 2021.

    Page 3 of 3

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