CARLA MURPHY
Dependent on policy B07M000058
Claims
2
Attributed to this person
Charged
1,447.00
Total submitted
Denied
655.00
1 denied claims
Patient responsibility
118.80
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 | CARLA MURPHY |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000058 |
| Date of birth | 1 Dec 2002 |
| Plan | PLATINUM PPO |
| Covered from | 17 Mar 2024 |
| Covered to | 27 Sep 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 118.80 |
| Total | 118.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000262 | 14 Jun 2024 | 792.00 | CASCADE CARE | Not denied | — |
| CLM0000263 | 1 May 2024 | 655.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 655.00 |