UMA WILSON
Subscriber on policy B09M000545
Claims
2
Attributed to this person
Charged
914.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
261.30
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 | UMA WILSON |
| Role on the policy | Subscriber |
| Policy | B09M000545 |
| Date of birth | 22 Dec 1969 |
| Plan | BRONZE EPO |
| Covered from | 17 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 261.30 |
| Total | 261.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002287 | 17 Jan 2026 | 402.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0002288 | 30 Jul 2025 | 512.00 | MERIDIAN HEALTH PLAN | Not denied | — |