KEVIN ANDERSON
Subscriber on policy B08M000304
Claims
1
Attributed to this person
Charged
856.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
171.20
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B08M000304 |
| Date of birth | 8 Sep 1984 |
| Plan | BRONZE EPO |
| Covered from | 30 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 171.20 |
| Total | 171.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001410 | 15 Apr 2026 | 856.00 | CASCADE CARE | Not denied | — |