WENDY WILSON
Subscriber on policy B09M000135
Claims
3
Attributed to this person
Charged
1,878.00
Total submitted
Denied
1,382.00
2 denied claims
Patient responsibility
74.40
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 | WENDY WILSON |
| Role on the policy | Subscriber |
| Policy | B09M000135 |
| Date of birth | 6 Jul 1978 |
| Plan | SILVER HMO |
| Covered from | 29 Jan 2025 |
| Covered to | 10 May 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 74.40 |
| Total | 74.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000548 | 14 Apr 2025 | 720.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 720.00 |
| CLM0000550 | 1 Apr 2025 | 496.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000549 | 15 Jan 2025 | 662.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 662.00 |