DAVID WILSON
Dependent on policy B08M000300
Claims
2
Attributed to this person
Charged
1,521.00
Total submitted
Denied
715.00
1 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 | Dependent · relationship 19 |
| Policy | B08M000300 |
| Date of birth | 6 Aug 2022 |
| Plan | BRONZE EPO |
| Covered from | 7 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001397 | 25 Sep 2025 | 806.00 | CASCADE CARE | Not denied | — |
| CLM0001396 | 15 Aug 2025 | 715.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 715.00 |