PRIYA ANDERSON
Subscriber on policy B06M000883
Claims
3
Attributed to this person
Charged
2,003.00
Total submitted
Denied
732.00
2 denied claims
Patient responsibility
406.25
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 | PRIYA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B06M000883 |
| Date of birth | 20 Sep 1987 |
| Plan | GOLD PPO |
| Covered from | 15 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 406.25 |
| Total | 406.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003845 | 23 Apr 2026 | 732.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 732.00 |
| CLM0003844 | 18 Dec 2025 | 646.00 | CASCADE CARE | Not denied | — |
| CLM0003843 | 9 May 2024 | 625.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |