JULIA ANDERSON
Subscriber on policy B02M000092
Claims
2
Attributed to this person
Charged
263.00
Total submitted
Denied
119.00
1 denied claims
Patient responsibility
28.80
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 | JULIA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B02M000092 |
| Date of birth | 14 May 1983 |
| Plan | SILVER HMO |
| Covered from | 19 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 28.80 |
| Total | 28.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000419 | 19 Sep 2025 | 119.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 119.00 |
| CLM0000420 | 18 May 2025 | 144.00 | CASCADE CARE | Not denied | — |