BRIAN WILSON
Subscriber on policy B01M000043
Claims
3
Attributed to this person
Charged
1,137.00
Total submitted
Denied
76.38
2 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
| Field | Value |
|---|---|
| Name | BRIAN WILSON |
| Role on the policy | Subscriber |
| Policy | B01M000043 |
| Date of birth | 14 Aug 1975 |
| Plan | PLATINUM PPO |
| Covered from | 26 Nov 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0000170 | 3 Dec 2025 | 371.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000169 | 7 Jan 2025 | 656.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 26.42 |
| CLM0000171 | 12 Dec 2024 | 110.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 49.96 |