ZARA ANDERSON
Subscriber on policy B07M000107
Claims
3
Attributed to this person
Charged
1,696.00
Total submitted
Denied
741.00
1 denied claims
Patient responsibility
39.60
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B07M000107 |
| Date of birth | 11 Mar 1983 |
| Plan | BRONZE EPO |
| Covered from | 12 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 39.60 |
| Total | 39.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000439 | 13 Jun 2026 | 198.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000440 | 5 Nov 2024 | 757.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000438 | 27 Sep 2024 | 741.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 741.00 |