X12 Ingest & Denial Analytics

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Members›policy B02M000050›TOMAS PATEL

TOMAS PATEL

Dependent on policy B02M000050

Claims
1
Attributed to this person
Charged
93.00
Total submitted
Denied
0.00
0 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

FieldValue
NameTOMAS PATEL
Role on the policyDependent · relationship 01
PolicyB02M000050
Date of birth6 Dec 1992
PlanBRONZE EPO
Covered from29 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000023913 Oct 202593.00MERIDIAN HEALTH PLANNot denied—