VICTOR WILSON
Dependent on policy B08M000279
Claims
3
Attributed to this person
Charged
1,420.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
126.80
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 WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000279 |
| Date of birth | 12 Feb 1969 |
| Plan | SILVER HMO |
| Covered from | 4 Dec 2024 |
| Covered to | 14 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 126.80 |
| Total | 126.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001271 | 27 Sep 2025 | 139.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001273 | 31 Aug 2025 | 647.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001272 | 28 Dec 2024 | 634.00 | MERIDIAN HEALTH PLAN | Not denied | — |