DAVID MURPHY
Dependent on policy B10M000524
Claims
2
Attributed to this person
Charged
927.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
109.35
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 | DAVID MURPHY |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000524 |
| Date of birth | 23 Sep 2011 |
| Plan | GOLD PPO |
| Covered from | 31 Aug 2024 |
| Covered to | 25 Apr 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 109.35 |
| Total | 109.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002169 | 27 Mar 2025 | 729.00 | CASCADE CARE | Not denied | — |
| CLM0002168 | 12 Mar 2025 | 198.00 | CASCADE CARE | Not denied | — |