ZARA ANDERSON
Subscriber on policy B07M000663
Claims
2
Attributed to this person
Charged
1,048.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
479.70
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 | ZARA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B07M000663 |
| Date of birth | 6 Jan 1987 |
| Plan | GOLD PPO |
| Covered from | 8 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 479.70 |
| Total | 479.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002763 | 15 Jul 2025 | 310.00 | CASCADE CARE | Not denied | — |
| CLM0002764 | 21 Apr 2025 | 738.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |