X12 Ingest & Denial Analytics

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Members›policy B08M000428›MARCUS EVANS

MARCUS EVANS

Dependent on policy B08M000428

Claims
3
Attributed to this person
Charged
1,350.00
Total submitted
Denied
506.00
1 denied claims
Patient responsibility
0.00
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

FieldValue
NameMARCUS EVANS
Role on the policyDependent · relationship 01
PolicyB08M000428
Date of birth3 Sep 1959
PlanGOLD PPO
Covered from15 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00019691 Aug 2026506.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION506.00
CLM000196727 Aug 2025415.00MERIDIAN HEALTH PLANNot denied—
CLM00019685 Apr 2024429.00MERIDIAN HEALTH PLANNot denied—