AMARA PATEL
Subscriber on policy B01M000053
Claims
2
Attributed to this person
Charged
502.00
Total submitted
Denied
290.00
1 denied claims
Patient responsibility
42.40
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 | AMARA PATEL |
| Role on the policy | Subscriber |
| Policy | B01M000053 |
| Date of birth | 28 Dec 1990 |
| Plan | GOLD PPO |
| Covered from | 2 May 2025 |
| Covered to | 12 Jan 2026 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 42.40 |
| Total | 42.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000213 | 12 Dec 2025 | 290.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 290.00 |
| CLM0000212 | 19 Jul 2025 | 212.00 | MERIDIAN HEALTH PLAN | Not denied | — |