KEVIN WILSON
Subscriber on policy B07M000227
Claims
2
Attributed to this person
Charged
1,037.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
75.75
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 | KEVIN WILSON |
| Role on the policy | Subscriber |
| Policy | B07M000227 |
| Date of birth | 23 Apr 1980 |
| Plan | PLATINUM PPO |
| Covered from | 17 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 75.75 |
| Total | 75.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000958 | 29 Jan 2025 | 532.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000959 | 27 Apr 2024 | 505.00 | MERIDIAN HEALTH PLAN | Not denied | — |