LEILA ANDERSON
Subscriber on policy B09M000248
Claims
3
Attributed to this person
Charged
859.00
Total submitted
Denied
188.72
2 denied claims
Patient responsibility
41.85
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 | LEILA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B09M000248 |
| Date of birth | 8 Sep 1981 |
| Plan | SILVER HMO |
| Covered from | 20 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 41.85 |
| Total | 41.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001004 | 11 Aug 2026 | 517.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 125.72 |
| CLM0001005 | 7 Jul 2026 | 63.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 63.00 |
| CLM0001006 | 21 May 2025 | 279.00 | MERIDIAN HEALTH PLAN | Not denied | — |