UMA PATEL
Subscriber on policy B10M000555
Claims
3
Attributed to this person
Charged
1,979.00
Total submitted
Denied
1,512.00
2 denied claims
Patient responsibility
70.05
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 | UMA PATEL |
| Role on the policy | Subscriber |
| Policy | B10M000555 |
| Date of birth | 13 Jan 1999 |
| Plan | BRONZE EPO |
| Covered from | 22 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 70.05 |
| Total | 70.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002293 | 9 Apr 2026 | 882.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 882.00 |
| CLM0002294 | 2 Apr 2025 | 630.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 630.00 |
| CLM0002295 | 2 Aug 2024 | 467.00 | CASCADE CARE | Not denied | — |