WENDY WILSON
Subscriber on policy B10M000164
Claims
2
Attributed to this person
Charged
1,252.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
59.70
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 | WENDY WILSON |
| Role on the policy | Subscriber |
| Policy | B10M000164 |
| Date of birth | 4 Jan 1994 |
| Plan | GOLD PPO |
| Covered from | 4 Apr 2025 |
| Covered to | 5 Jan 2026 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 59.70 |
| Total | 59.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000678 | 20 Nov 2025 | 854.00 | CASCADE CARE | Not denied | — |
| CLM0000679 | 31 May 2025 | 398.00 | CASCADE CARE | Not denied | — |