VICTOR PATEL
Subscriber on policy B07M000779
Claims
1
Attributed to this person
Charged
273.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
177.45
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 | VICTOR PATEL |
| Role on the policy | Subscriber |
| Policy | B07M000779 |
| Date of birth | 2 Sep 1955 |
| Plan | BRONZE EPO |
| Covered from | 14 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 177.45 |
| Total | 177.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003223 | 16 Apr 2026 | 273.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |