KEVIN ANDERSON
Subscriber on policy B02M000360
Claims
2
Attributed to this person
Charged
1,270.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
25.00
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 | KEVIN ANDERSON |
| Role on the policy | Subscriber |
| Policy | B02M000360 |
| Date of birth | 10 Jan 1950 |
| Plan | GOLD PPO |
| Covered from | 15 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001546 | 16 Jul 2025 | 552.00 | CASCADE CARE | Not denied | — |
| CLM0001547 | 25 Sep 2024 | 718.00 | CASCADE CARE | Not denied | — |