BRIAN WILSON
Subscriber on policy B09M000675
Claims
1
Attributed to this person
Charged
868.00
Total submitted
Denied
296.09
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 | BRIAN WILSON |
| Role on the policy | Subscriber |
| Policy | B09M000675 |
| Date of birth | 20 Oct 1991 |
| Plan | BRONZE EPO |
| Covered from | 15 Nov 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 |
|---|---|---|---|---|---|
| CLM0002876 | 7 Feb 2026 | 868.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 296.09 |