UMA PATEL
Subscriber on policy B01M000684
Claims
2
Attributed to this person
Charged
1,340.00
Total submitted
Denied
682.00
1 denied claims
Patient responsibility
98.70
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 | UMA PATEL |
| Role on the policy | Subscriber |
| Policy | B01M000684 |
| Date of birth | 22 Feb 1955 |
| Plan | PLATINUM PPO |
| Covered from | 1 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 98.70 |
| Total | 98.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003066 | 14 Jul 2025 | 658.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003067 | 30 May 2025 | 682.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 682.00 |