ZARA ANDERSON
Subscriber on policy B03M000114
Claims
1
Attributed to this person
Charged
494.00
Total submitted
Denied
494.00
1 denied claims
Patient responsibility
0.00
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 | ZARA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B03M000114 |
| Date of birth | 1 Feb 1999 |
| Plan | BRONZE EPO |
| Covered from | 31 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000447 | 10 Dec 2024 | 494.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 494.00 |