An itemized receipt is a receipt that contains the following five pieces of information:
- Patient's Name: The name of the person who received the service or for whom the item was purchased. For retail store purchases, this information may be excluded.
- Provider's Name: The provider that delivered the service or where the item was purchased.
- Date of Service: The date when services were provided or the item was purchased.
- Type of Service: A detailed description of the service provided or item purchased. A bag tag is sufficient for prescriptions.
- Cost: The amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.
We may ask you for an itemized receipt in order to verify that your transaction was for an eligible expense per IRS guidelines.