CARLA ANDERSON
Dependent on policy B07M000117
Claims
3
Attributed to this person
Charged
1,434.00
Total submitted
Denied
751.00
2 denied claims
Patient responsibility
184.45
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 | Dependent · relationship 01 |
| Policy | B07M000117 |
| Date of birth | 3 Oct 1979 |
| Plan | SILVER HMO |
| Covered from | 8 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 106.60 |
| CARC 1 · Deductible | 1 | 77.85 |
| Total | 184.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000483 | 6 May 2026 | 751.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 751.00 |
| CLM0000484 | 9 Nov 2025 | 164.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000485 | 13 Feb 2025 | 519.00 | MERIDIAN HEALTH PLAN | Not denied | — |