TOMAS MURPHY
Dependent on policy B02M000658
Claims
3
Attributed to this person
Charged
1,664.00
Total submitted
Denied
861.00
2 denied claims
Patient responsibility
254.80
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 | TOMAS MURPHY |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000658 |
| Date of birth | 31 Dec 1996 |
| Plan | GOLD PPO |
| Covered from | 24 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 254.80 |
| Total | 254.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002773 | 28 Nov 2025 | 411.00 | CASCADE CARE | Not denied | — |
| CLM0002774 | 13 Mar 2025 | 861.00 | CASCADE CARE | CARC 11 · CODING | 861.00 |
| CLM0002772 | 9 Feb 2025 | 392.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |