AMARA MURPHY
Dependent on policy B10M000216
Claims
1
Attributed to this person
Charged
449.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
291.85
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 | AMARA MURPHY |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000216 |
| Date of birth | 30 Nov 1961 |
| Plan | SILVER HMO |
| Covered from | 23 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 291.85 |
| Total | 291.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000883 | 31 May 2024 | 449.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |