KEVIN WILSON
Subscriber on policy B07M000717
Claims
3
Attributed to this person
Charged
1,491.00
Total submitted
Denied
1,077.00
2 denied claims
Patient responsibility
62.10
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 | B07M000717 |
| Date of birth | 3 Jul 1987 |
| Plan | SILVER HMO |
| Covered from | 19 Nov 2024 |
| Covered to | 5 Feb 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 62.10 |
| Total | 62.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002961 | 13 Mar 2025 | 414.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002960 | 22 Feb 2025 | 552.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 552.00 |
| CLM0002959 | 9 Nov 2024 | 525.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 525.00 |