TOMAS MURPHY
Subscriber on policy B10M000782
Claims
2
Attributed to this person
Charged
928.00
Total submitted
Denied
457.58
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 | TOMAS MURPHY |
| Role on the policy | Subscriber |
| Policy | B10M000782 |
| Date of birth | 14 Jul 1971 |
| Plan | BRONZE EPO |
| Covered from | 11 Feb 2024 |
| Covered to | 18 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003297 | 20 Aug 2024 | 100.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 100.00 |
| CLM0003298 | 6 May 2024 | 828.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 357.58 |