AMARA WILSON
Dependent on policy B02M000358
Claims
3
Attributed to this person
Charged
2,408.00
Total submitted
Denied
271.92
2 denied claims
Patient responsibility
515.45
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 WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000358 |
| Date of birth | 3 Oct 2023 |
| Plan | PLATINUM PPO |
| Covered from | 28 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 515.45 |
| Total | 515.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001537 | 22 May 2026 | 793.00 | CASCADE CARE | Not denied | — |
| CLM0001536 | 7 Jan 2026 | 822.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 271.92 |
| CLM0001535 | 12 Aug 2025 | 793.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |