JULIA WILSON
Dependent on policy B02M000829
Claims
2
Attributed to this person
Charged
1,015.00
Total submitted
Denied
225.00
1 denied claims
Patient responsibility
118.50
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 | JULIA WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000829 |
| Date of birth | 21 May 1963 |
| Plan | GOLD PPO |
| Covered from | 10 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 118.50 |
| Total | 118.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003445 | 20 Jul 2025 | 225.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 225.00 |
| CLM0003444 | 21 May 2025 | 790.00 | MERIDIAN HEALTH PLAN | Not denied | — |