Question: Using the explanation below, answer the following questions: 01 / 20 / 20XX XYZ Insurance Company Explanation of Benefits Walden-Martin Family Medical Clinic 1234 Anystreet

Using the explanation below, answer the following
Using the explanation below, answer the following questions: 01 / 20 / 20XX XYZ Insurance Company Explanation of Benefits Walden-Martin Family Medical Clinic 1234 Anystreet Anytown, AK 12345-1234 Covered Deductible Co-Pay Payment Patient Treatment CPT Charge Reason Amount Paid At Amount Name Dates Code Amount Code Amount Amount Yan, Tai 01/06/20XX 0.00 80% 99205 132.28 03 125.00 0.00 100.00 01 /06 /20XX 0.00 80% 82947 15.00 15.00 0.00 12.00 01 /06 /20XX 86580 11.34 11.34 0.00 0.00 80% 9.07 Totals 158.62 151.34 121.07 Gomez, 01/07/20XX 99212 28.55 28.55 0.00 0.00 80% 22.84 Pedro Totals 28.55 28.55 22.84 Green, 01/04/20XX 99203 70.92 69.23 0.00 0.00 Jana 80% 01/04/20XX 71020 55.38 40.97 34.95 0.00 0.00 80% Totals 111.89 27.96 104.18 83.34 Reason Code: 03 Allowed amount per insurance contract Check No: 56390 $227.25 For Tai Yan's office visit, 99205, there is a difference between the Charge Amount and Covered Amount. Based on the reason code supplied what will be done with the difference

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