TOMAS PATEL
Dependent on policy B03M000422
Claims
3
Attributed to this person
Charged
1,090.00
Total submitted
Denied
545.39
2 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 | TOMAS PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000422 |
| Date of birth | 24 Apr 1996 |
| Plan | GOLD PPO |
| Covered from | 31 Jan 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 |
|---|---|---|---|---|---|
| CLM0001717 | 18 Nov 2025 | 492.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 492.00 |
| CLM0001718 | 8 Nov 2025 | 122.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 53.39 |
| CLM0001719 | 7 Sep 2025 | 476.00 | CASCADE CARE | Not denied | — |