HENRY PATEL
Dependent on policy B01M000383
Claims
2
Attributed to this person
Charged
641.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
38.00
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 | HENRY PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000383 |
| Date of birth | 17 Nov 1984 |
| Plan | GOLD PPO |
| Covered from | 16 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 38.00 |
| Total | 38.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001705 | 11 Oct 2025 | 190.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001704 | 3 Apr 2025 | 451.00 | MERIDIAN HEALTH PLAN | Not denied | — |