LEILA MURPHY
Dependent on policy B03M000566
Claims
2
Attributed to this person
Charged
1,187.00
Total submitted
Denied
495.00
2 denied claims
Patient responsibility
449.80
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 | LEILA MURPHY |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000566 |
| Date of birth | 5 Sep 1999 |
| Plan | SILVER HMO |
| Covered from | 25 Apr 2025 |
| Covered to | 29 Jul 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 449.80 |
| Total | 449.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002310 | 3 Aug 2025 | 495.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 495.00 |
| CLM0002311 | 8 Jun 2025 | 692.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |