DAVID ANDERSON
Subscriber on policy B05M000338
Claims
3
Attributed to this person
Charged
937.00
Total submitted
Denied
698.66
3 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 | DAVID ANDERSON |
| Role on the policy | Subscriber |
| Policy | B05M000338 |
| Date of birth | 11 Feb 1954 |
| Plan | PLATINUM PPO |
| Covered from | 12 Apr 2025 |
| Covered to | 13 Jun 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 |
|---|---|---|---|---|---|
| CLM0001439 | 22 Jun 2025 | 166.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 166.00 |
| CLM0001440 | 4 May 2025 | 443.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 204.66 |
| CLM0001438 | 23 Apr 2025 | 328.00 | CASCADE CARE | CARC 18 · DUPLICATE | 328.00 |