KEVIN WILSON
Subscriber on policy B06M000873
Claims
3
Attributed to this person
Charged
2,072.00
Total submitted
Denied
1,743.00
2 denied claims
Patient responsibility
49.35
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 | KEVIN WILSON |
| Role on the policy | Subscriber |
| Policy | B06M000873 |
| Date of birth | 26 Feb 1959 |
| Plan | PLATINUM PPO |
| Covered from | 11 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 49.35 |
| Total | 49.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003807 | 19 Jun 2026 | 892.00 | CASCADE CARE | CARC 11 · CODING | 892.00 |
| CLM0003805 | 31 Oct 2025 | 851.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 851.00 |
| CLM0003806 | 8 Jul 2025 | 329.00 | CASCADE CARE | Not denied | — |