IVAN ANDERSON
Dependent on policy B09M000088
Claims
2
Attributed to this person
Charged
1,117.00
Total submitted
Denied
507.00
1 denied claims
Patient responsibility
91.50
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 | IVAN ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000088 |
| Date of birth | 4 Mar 1968 |
| Plan | PLATINUM PPO |
| Covered from | 18 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 91.50 |
| Total | 91.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000372 | 27 Sep 2025 | 610.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000373 | 3 Mar 2025 | 507.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 507.00 |