IVAN ANDERSON
Subscriber on policy B03M000773
Claims
1
Attributed to this person
Charged
394.00
Total submitted
Denied
394.00
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 | IVAN ANDERSON |
| Role on the policy | Subscriber |
| Policy | B03M000773 |
| Date of birth | 16 Oct 2004 |
| Plan | BRONZE EPO |
| Covered from | 29 Jan 2025 |
| Covered to | 5 Jul 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003262 | 25 Jan 2025 | 394.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 394.00 |