DAVID PATEL
Dependent on policy B03M000757
Claims
1
Attributed to this person
Charged
578.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
86.70
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 | DAVID PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000757 |
| Date of birth | 16 Feb 2006 |
| Plan | GOLD PPO |
| Covered from | 21 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 86.70 |
| Total | 86.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003182 | 24 Feb 2026 | 578.00 | CASCADE CARE | Not denied | — |