JULIA WILSON
Dependent on policy B01M000456
Claims
2
Attributed to this person
Charged
1,284.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
114.15
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 | JULIA WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000456 |
| Date of birth | 10 Feb 2017 |
| Plan | PLATINUM PPO |
| Covered from | 29 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 114.15 |
| Total | 114.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002044 | 12 Jul 2025 | 761.00 | CASCADE CARE | Not denied | — |
| CLM0002043 | 27 May 2025 | 523.00 | CASCADE CARE | Not denied | — |