PRIYA WILSON
Dependent on policy B10M000260
Claims
3
Attributed to this person
Charged
892.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
39.80
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 | PRIYA WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000260 |
| Date of birth | 3 Dec 1994 |
| Plan | BRONZE EPO |
| Covered from | 9 Jul 2024 |
| Covered to | 26 Mar 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 39.80 |
| Total | 39.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001070 | 28 Jan 2025 | 335.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001069 | 26 Dec 2024 | 358.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001068 | 25 Jun 2024 | 199.00 | MERIDIAN HEALTH PLAN | Not denied | — |