LEILA PATEL
Subscriber on policy B09M000715
Claims
2
Attributed to this person
Charged
650.00
Total submitted
Denied
343.00
1 denied claims
Patient responsibility
61.40
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 | LEILA PATEL |
| Role on the policy | Subscriber |
| Policy | B09M000715 |
| Date of birth | 24 Aug 1950 |
| Plan | BRONZE EPO |
| Covered from | 26 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 61.40 |
| Total | 61.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003029 | 28 Jul 2026 | 307.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003030 | 15 Feb 2025 | 343.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 343.00 |