DAVID WILSON
Subscriber on policy B06M000800
Claims
2
Attributed to this person
Charged
635.00
Total submitted
Denied
635.00
2 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 | DAVID WILSON |
| Role on the policy | Subscriber |
| Policy | B06M000800 |
| Date of birth | 12 Jul 1982 |
| Plan | SILVER HMO |
| Covered from | 5 May 2025 |
| Covered to | 3 Sep 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003516 | 23 Sep 2025 | 82.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 82.00 |
| CLM0003515 | 26 Apr 2025 | 553.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 553.00 |