LEILA ANDERSON
Subscriber on policy B08M000070
Claims
2
Attributed to this person
Charged
1,728.00
Total submitted
Denied
195.90
1 denied claims
Patient responsibility
127.05
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 | LEILA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B08M000070 |
| Date of birth | 24 Sep 1954 |
| Plan | BRONZE EPO |
| Covered from | 5 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 127.05 |
| Total | 127.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000313 | 9 Dec 2025 | 881.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 195.90 |
| CLM0000312 | 28 Nov 2025 | 847.00 | MERIDIAN HEALTH PLAN | Not denied | — |