VICTOR PATEL
Subscriber on policy B06M000388
Claims
1
Attributed to this person
Charged
649.00
Total submitted
Denied
254.78
1 denied claims
Patient responsibility
0.00
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | VICTOR PATEL |
| Role on the policy | Subscriber |
| Policy | B06M000388 |
| Date of birth | 25 Sep 1980 |
| Plan | GOLD PPO |
| Covered from | 10 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001764 | 14 Dec 2024 | 649.00 | CASCADE CARE | CARC 96 · NON_COVERED | 254.78 |