IVAN ANDERSON
Dependent on policy B04M000408
Claims
1
Attributed to this person
Charged
698.00
Total submitted
Denied
698.00
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 | Dependent · relationship 01 |
| Policy | B04M000408 |
| Date of birth | 19 Apr 1993 |
| Plan | BRONZE EPO |
| Covered from | 8 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001743 | 27 Jan 2025 | 698.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 698.00 |