DAVID PATEL
Dependent on policy B05M000550
Claims
3
Attributed to this person
Charged
1,239.00
Total submitted
Denied
137.00
1 denied claims
Patient responsibility
58.50
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 PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000550 |
| Date of birth | 22 Dec 1975 |
| Plan | PLATINUM PPO |
| Covered from | 17 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 58.50 |
| Total | 58.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002352 | 15 Mar 2026 | 712.00 | CASCADE CARE | Not denied | — |
| CLM0002354 | 17 Jul 2025 | 390.00 | CASCADE CARE | Not denied | — |
| CLM0002353 | 7 Oct 2024 | 137.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 137.00 |