KEVIN WILSON
Dependent on policy B03M000689
Claims
2
Attributed to this person
Charged
703.00
Total submitted
Denied
589.00
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 | KEVIN WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000689 |
| Date of birth | 26 Apr 2013 |
| Plan | PLATINUM PPO |
| Covered from | 20 Jun 2025 |
| Covered to | 21 Jan 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 |
|---|---|---|---|---|---|
| CLM0002868 | 4 Sep 2025 | 589.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 589.00 |
| CLM0002869 | 14 Aug 2025 | 114.00 | CASCADE CARE | Not denied | — |