OMAR PATEL
Dependent on policy B06M000772
Claims
2
Attributed to this person
Charged
705.00
Total submitted
Denied
705.00
2 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 | OMAR PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000772 |
| Date of birth | 27 May 1965 |
| Plan | SILVER HMO |
| Covered from | 23 May 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 |
|---|---|---|---|---|---|
| CLM0003409 | 25 Dec 2024 | 63.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 63.00 |
| CLM0003410 | 26 Apr 2024 | 642.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 642.00 |