LEILA PATEL
Dependent on policy B06M000570
Claims
2
Attributed to this person
Charged
473.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
249.60
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 | LEILA PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000570 |
| Date of birth | 16 Jan 2020 |
| Plan | PLATINUM PPO |
| Covered from | 13 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 249.60 |
| Total | 249.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002554 | 23 May 2026 | 384.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0002555 | 22 Sep 2025 | 89.00 | CASCADE CARE | Not denied | — |