IVAN WILSON
Subscriber on policy B10M000052
Claims
1
Attributed to this person
Charged
764.00
Total submitted
Denied
365.90
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 | IVAN WILSON |
| Role on the policy | Subscriber |
| Policy | B10M000052 |
| Date of birth | 16 Jul 1973 |
| Plan | SILVER HMO |
| Covered from | 1 Oct 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 |
|---|---|---|---|---|---|
| CLM0000207 | 20 Jul 2025 | 764.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 365.90 |