HENRY ANDERSON
Subscriber on policy B03M000548
Claims
1
Attributed to this person
Charged
708.00
Total submitted
Denied
284.69
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 โ 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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B03M000548 |
| Date of birth | 28 Jan 1965 |
| Plan | SILVER HMO |
| Covered from | 31 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002256 | 24 Aug 2025 | 708.00 | MERIDIAN HEALTH PLAN | CARC 197 ยท AUTHORIZATION | 284.69 |