HENRY PATEL
Dependent on policy B05M000486
Claims
3
Attributed to this person
Charged
2,023.00
Total submitted
Denied
1,462.00
2 denied claims
Patient responsibility
84.15
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 | HENRY PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000486 |
| Date of birth | 29 Oct 2015 |
| Plan | SILVER HMO |
| Covered from | 10 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 84.15 |
| Total | 84.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002063 | 9 Dec 2025 | 561.00 | CASCADE CARE | Not denied | — |
| CLM0002062 | 13 Nov 2025 | 813.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 813.00 |
| CLM0002061 | 3 Oct 2024 | 649.00 | CASCADE CARE | CARC 11 · CODING | 649.00 |