CARLA WILSON
Dependent on policy B04M000559
Claims
3
Attributed to this person
Charged
818.00
Total submitted
Denied
177.00
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 | CARLA WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000559 |
| Date of birth | 13 Mar 1991 |
| Plan | PLATINUM PPO |
| Covered from | 1 Aug 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002457 | 16 Jun 2026 | 549.00 | CASCADE CARE | Not denied | — |
| CLM0002456 | 3 Nov 2024 | 92.00 | CASCADE CARE | Not denied | — |
| CLM0002455 | 24 Jul 2024 | 177.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 177.00 |