Page 17 - Cover Letter and Medicare evaluation for Dr. Peter Yesawich
P. 17
Client Data Sheet
Client ID: 11272020b November 28, 2020
Please verify the accuracy of the information below
Client's DOB: 10/28/50
Date that Medicare became or will become primary (when
client has both Part A & Part B): 01/01/21
Client's home zip code: 33432
Has client started receiving Social Security or SSDI payments? Yes
After client retires, will he or she have access to health
insurance through a spouse's or ex-spouse's employer plan? No
Client's Selection Criteria Does the Medicare
web site indicate that
this doctor accepts
Continue to see following physicians:
Medicare-approved
rates?
Dr. Jeanne E. Farley Internist Yes
Dr. Robert Piloto Internist Yes
Dr. Mary Russell Ophthalmologist Yes
Client wishes to compare both types of supplemental coverage
Prescription Drugs
Pharmacy CVS
Refill schedule Monthly
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