IVAN PATEL
Dependent on policy B03M000711
Claims
1
Attributed to this person
Charged
423.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
15.00
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 | IVAN PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000711 |
| Date of birth | 18 May 1972 |
| Plan | GOLD PPO |
| Covered from | 18 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 15.00 |
| Total | 15.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002977 | 23 Mar 2026 | 423.00 | MERIDIAN HEALTH PLAN | Not denied | — |