UMA WILSON
Dependent on policy B02M000038
Claims
3
Attributed to this person
Charged
1,438.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
154.20
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 WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000038 |
| Date of birth | 10 Jan 2004 |
| Plan | SILVER HMO |
| Covered from | 1 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 154.20 |
| Total | 154.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000186 | 9 Nov 2025 | 443.00 | CASCADE CARE | Not denied | — |
| CLM0000185 | 27 Mar 2025 | 224.00 | CASCADE CARE | Not denied | — |
| CLM0000187 | 31 Jul 2024 | 771.00 | CASCADE CARE | Not denied | — |