CARLA ANDERSON
Subscriber on policy B05M000863
Claims
1
Attributed to this person
Charged
237.00
Total submitted
Denied
237.00
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B05M000863 |
| Date of birth | 30 May 1953 |
| Plan | SILVER HMO |
| Covered from | 18 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 |
|---|---|---|---|---|---|
| CLM0003661 | 26 Jun 2026 | 237.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 237.00 |