IVAN ANDERSON
Subscriber on policy B03M000195
Claims
3
Attributed to this person
Charged
1,572.00
Total submitted
Denied
1,572.00
3 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 | IVAN ANDERSON |
| Role on the policy | Subscriber |
| Policy | B03M000195 |
| Date of birth | 23 Apr 1975 |
| Plan | SILVER HMO |
| Covered from | 19 Jun 2025 |
| Covered to | 9 Feb 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000804 | 10 Aug 2025 | 217.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 217.00 |
| CLM0000802 | 24 Jul 2025 | 551.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 551.00 |
| CLM0000803 | 4 Jun 2025 | 804.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 804.00 |