LEILA ANDERSON
Subscriber on policy B09M000279
Claims
1
Attributed to this person
Charged
216.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
43.20
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 | B09M000279 |
| Date of birth | 10 Sep 1995 |
| Plan | SILVER HMO |
| Covered from | 20 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 43.20 |
| Total | 43.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001147 | 9 Aug 2026 | 216.00 | MERIDIAN HEALTH PLAN | Not denied | — |