KEVIN WILSON
Dependent on policy B09M000123
Claims
2
Attributed to this person
Charged
417.00
Total submitted
Denied
417.00
2 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
| Field | Value |
|---|---|
| Name | KEVIN WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000123 |
| Date of birth | 26 Dec 2016 |
| Plan | SILVER HMO |
| Covered from | 12 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000508 | 14 Jun 2026 | 355.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 355.00 |
| CLM0000507 | 25 Aug 2025 | 62.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 62.00 |