VICTOR PATEL
Dependent on policy B05M000550
Claims
3
Attributed to this person
Charged
1,029.00
Total submitted
Denied
202.00
2 denied claims
Patient responsibility
360.10
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 PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000550 |
| Date of birth | 12 Jan 2015 |
| Plan | PLATINUM PPO |
| Covered from | 17 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 360.10 |
| Total | 360.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002355 | 17 Apr 2026 | 554.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0002357 | 26 Jul 2025 | 273.00 | CASCADE CARE | Not denied | — |
| CLM0002356 | 31 Jan 2025 | 202.00 | CASCADE CARE | CARC 18 · DUPLICATE | 202.00 |