HENRY MURPHY
Subscriber on policy B04M000246
Claims
1
Attributed to this person
Charged
262.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
52.40
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 | HENRY MURPHY |
| Role on the policy | Subscriber |
| Policy | B04M000246 |
| Date of birth | 30 Dec 1990 |
| Plan | PLATINUM PPO |
| Covered from | 10 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 52.40 |
| Total | 52.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001075 | 18 Jul 2025 | 262.00 | MERIDIAN HEALTH PLAN | Not denied | — |