ELENA WILSON
Dependent on policy B05M000657
Claims
3
Attributed to this person
Charged
1,793.00
Total submitted
Denied
1,793.00
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 | ELENA WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000657 |
| Date of birth | 22 Apr 1950 |
| Plan | SILVER HMO |
| Covered from | 7 Jun 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0002827 | 1 Jun 2026 | 321.00 | CASCADE CARE | CARC 96 · NON_COVERED | 321.00 |
| CLM0002826 | 4 Feb 2026 | 663.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 663.00 |
| CLM0002828 | 29 Oct 2025 | 809.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 809.00 |