VICTOR WILSON
Subscriber on policy B04M000678
Claims
2
Attributed to this person
Charged
846.00
Total submitted
Denied
95.90
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 | VICTOR WILSON |
| Role on the policy | Subscriber |
| Policy | B04M000678 |
| Date of birth | 14 Oct 1966 |
| Plan | BRONZE EPO |
| Covered from | 14 Apr 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 |
|---|---|---|---|---|---|
| CLM0002955 | 1 Aug 2026 | 535.00 | CASCADE CARE | Not denied | — |
| CLM0002956 | 8 Aug 2024 | 311.00 | CASCADE CARE | CARC 109 · COB | 95.90 |