CARLA PATEL
Dependent on policy B03M000208
Claims
3
Attributed to this person
Charged
1,660.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
413.40
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 | CARLA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000208 |
| Date of birth | 6 Dec 1983 |
| Plan | PLATINUM PPO |
| Covered from | 10 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 413.40 |
| Total | 413.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000854 | 2 Aug 2026 | 242.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000853 | 14 Dec 2025 | 636.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000855 | 16 Feb 2025 | 782.00 | MERIDIAN HEALTH PLAN | Not denied | — |