i just need the par provider write off amount and the par provider balance billing amount. i just need the answer for the last column in each section. thank you

Instruction: Using the Table below calculate the WRITE OFF AND BALANCE BILLING amount of the following cases. EVALUATION AND MANAGEMENT FOR NEW PATIENT CPT CODES DESCRIPTIO PARTICIPATIN NON- ALLOWABLE G PROVIDER PARTICIPATIN CHARGES (FEE) G PROVIDER (FEE) 99201 Level 1 Problem 30.43 28.91 26.51 Focused 99202 Level 2 47.52 45.14 41.60 Expanded Problem Focus 99203 Level 3 Detailed 64.92 61.67 60.01 99204 Level 4 97.13 92.27 89.90 Comprehensive 99205 Level 5 121.08 115.03 110.30 Comprehensive EVALUATION AND MANAGEMENT FOR ESTABLISHED PATIENT CPT CODES DESCRIPTIO PARTICIPATIN NON- ALLOWABLE N G PROVIDER PARTICIPATIN CHARGES (FEE) G PROVIDER (FEE) 99211 Level 1 14.70 13.97 10.05 Nurse Visit 99212 Level 2 Problem 26.14 24.83 22.70 Focused 99213 Level 3 36.80 34.96 32.40 Expanded Problem Focus 99214 Level 4 56.31 53.79 50.20 Comprehensive 99215 Level 5 88.76 84.32 80.50 Comprehensive Case #1 Medical service provide to an established patient by the participating provider is Level 4 Comprehensive. Provide the necessary information. CPT Code Participating Provider Fee Allowable charge PAR provider Write- off amount Case #2 Medical service provide to a new patient by the NoN- Participating provider is Level 5 Comprehensive. Provide the necessary information. CPT Code Allowable charge Non Participating Provider Fee Non PAR Provider Balance billing amount Case #3 Medical service provide to a new patient by the NON- Participating provider is Level 4 Comprehensive. Provide the necessary information. CPT Code Allowable charge Non Participating Provider Fee Non PAR Provider Balance billing amount Case #4 Medical service provide to a new patient by the Participating provider is Level 3 Detailed. Provide the necessary information. CPT Code Participating Allowable charge PAR Provider Provider Fee Write-off Case #5 Medical service provide to an established by the NoN- Participating provider is Level 2 Problem focused. Provide the necessary information. CPT Code Non Participating Provider Fee Allowable charge Non PAR Provider Balance billing amount Instruction: Using the Table below calculate the WRITE OFF AND BALANCE BILLING amount of the following cases. EVALUATION AND MANAGEMENT FOR NEW PATIENT CPT CODES DESCRIPTIO PARTICIPATIN NON- ALLOWABLE G PROVIDER PARTICIPATIN CHARGES (FEE) G PROVIDER (FEE) 99201 Level 1 Problem 30.43 28.91 26.51 Focused 99202 Level 2 47.52 45.14 41.60 Expanded Problem Focus 99203 Level 3 Detailed 64.92 61.67 60.01 99204 Level 4 97.13 92.27 89.90 Comprehensive 99205 Level 5 121.08 115.03 110.30 Comprehensive EVALUATION AND MANAGEMENT FOR ESTABLISHED PATIENT CPT CODES DESCRIPTIO PARTICIPATIN NON- ALLOWABLE N G PROVIDER PARTICIPATIN CHARGES (FEE) G PROVIDER (FEE) 99211 Level 1 14.70 13.97 10.05 Nurse Visit 99212 Level 2 Problem 26.14 24.83 22.70 Focused 99213 Level 3 36.80 34.96 32.40 Expanded Problem Focus 99214 Level 4 56.31 53.79 50.20 Comprehensive 99215 Level 5 88.76 84.32 80.50 Comprehensive Case #1 Medical service provide to an established patient by the participating provider is Level 4 Comprehensive. Provide the necessary information. CPT Code Participating Provider Fee Allowable charge PAR provider Write- off amount Case #2 Medical service provide to a new patient by the NoN- Participating provider is Level 5 Comprehensive. Provide the necessary information. CPT Code Allowable charge Non Participating Provider Fee Non PAR Provider Balance billing amount Case #3 Medical service provide to a new patient by the NON- Participating provider is Level 4 Comprehensive. Provide the necessary information. CPT Code Allowable charge Non Participating Provider Fee Non PAR Provider Balance billing amount Case #4 Medical service provide to a new patient by the Participating provider is Level 3 Detailed. Provide the necessary information. CPT Code Participating Allowable charge PAR Provider Provider Fee Write-off Case #5 Medical service provide to an established by the NoN- Participating provider is Level 2 Problem focused. Provide the necessary information. CPT Code Non Participating Provider Fee Allowable charge Non PAR Provider Balance billing amount