ZARA PATEL
Dependent on policy B05M000725
Claims
2
Attributed to this person
Charged
846.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
330.20
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 | ZARA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000725 |
| Date of birth | 13 Jan 1972 |
| Plan | BRONZE EPO |
| Covered from | 9 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 330.20 |
| Total | 330.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003104 | 20 Jun 2025 | 508.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0003105 | 1 Oct 2024 | 338.00 | CASCADE CARE | Not denied | — |