LEILA PATEL
Subscriber on policy B01M000717
Claims
1
Attributed to this person
Charged
713.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
106.95
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 | LEILA PATEL |
| Role on the policy | Subscriber |
| Policy | B01M000717 |
| Date of birth | 26 Jan 2000 |
| Plan | SILVER HMO |
| Covered from | 5 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 106.95 |
| Total | 106.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003190 | 20 Jul 2025 | 713.00 | MERIDIAN HEALTH PLAN | Not denied | — |