X12 Ingest & Denial Analytics

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Members›policy B08M000441›TOMAS WILSON

TOMAS WILSON

Dependent on policy B08M000441

Claims
2
Attributed to this person
Charged
1,134.00
Total submitted
Denied
0.00
0 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
NameTOMAS WILSON
Role on the policyDependent · relationship 01
PolicyB08M000441
Date of birth15 Jan 1996
PlanGOLD PPO
Covered from18 Mar 2025
Covered to12 Jul 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00020245 Jun 2025408.00MERIDIAN HEALTH PLANNot denied—
CLM00020254 Mar 2025726.00MERIDIAN HEALTH PLANNot denied—