X12 Ingest & Denial Analytics

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Members›policy B03M000346›CARLA WILSON

CARLA WILSON

Dependent on policy B03M000346

Claims
2
Attributed to this person
Charged
241.00
Total submitted
Denied
135.00
1 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
NameCARLA WILSON
Role on the policyDependent · relationship 01
PolicyB03M000346
Date of birth22 Oct 1989
PlanPLATINUM PPO
Covered from3 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000139611 Apr 2026106.00MERIDIAN HEALTH PLANNot denied—
CLM00013959 Jun 2025135.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION135.00