Common Contracts
1 similar Medicare Opt-Out Agreement contracts
Medicare Opt-out agreementMedicare Opt-Out Agreement • June 8th, 2017
This agreement (“Agreement”) is entered into by and between Blue Skies Family Medicine, a North Carolina professional corporation owned and operated by Katherine Weeks M.D. (“Physician”), whose principal medical office is located at 363 Williamson Road, Suite 103, Mooresville, NC 28117 and , a beneficiary enrolled in Medicare Part B (“Beneficiary”), who resides at _
