HENRY PATEL
Subscriber on policy B09M000893
Claims
2
Attributed to this person
Charged
887.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
15.00
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 | HENRY PATEL |
| Role on the policy | Subscriber |
| Policy | B09M000893 |
| Date of birth | 3 May 1978 |
| Plan | PLATINUM PPO |
| Covered from | 22 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 15.00 |
| Total | 15.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003813 | 30 Nov 2025 | 488.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003812 | 13 Oct 2024 | 399.00 | MERIDIAN HEALTH PLAN | Not denied | — |