IVAN WILSON
Dependent on policy B01M000230
Claims
2
Attributed to this person
Charged
626.00
Total submitted
Denied
376.68
2 denied claims
Patient responsibility
0.00
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 | IVAN WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000230 |
| Date of birth | 10 Sep 2007 |
| Plan | GOLD PPO |
| Covered from | 6 Nov 2024 |
| Covered to | 26 Feb 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000977 | 17 Apr 2025 | 169.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 169.00 |
| CLM0000976 | 1 Feb 2025 | 457.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 207.68 |