CARLA WILSON
Dependent on policy B05M000652
Claims
2
Attributed to this person
Charged
1,174.00
Total submitted
Denied
645.00
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 | CARLA WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000652 |
| Date of birth | 27 Mar 1990 |
| Plan | GOLD PPO |
| Covered from | 25 Jun 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 |
|---|---|---|---|---|---|
| CLM0002805 | 17 Jun 2026 | 645.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 645.00 |
| CLM0002804 | 14 Jan 2025 | 529.00 | CASCADE CARE | Not denied | — |