PRIYA ANDERSON
Dependent on policy B09M000121
Claims
2
Attributed to this person
Charged
1,108.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
53.00
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
| Field | Value |
|---|---|
| Name | PRIYA ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000121 |
| Date of birth | 15 Oct 1988 |
| Plan | GOLD PPO |
| Covered from | 22 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 53.00 |
| Total | 53.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000500 | 21 Nov 2025 | 843.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000501 | 11 Jan 2025 | 265.00 | MERIDIAN HEALTH PLAN | Not denied | — |