TOMAS PATEL
Subscriber on policy B04M000631
Claims
1
Attributed to this person
Charged
813.00
Total submitted
Denied
813.00
1 denied claims
Patient responsibility
0.00
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 | TOMAS PATEL |
| Role on the policy | Subscriber |
| Policy | B04M000631 |
| Date of birth | 1 Mar 1989 |
| Plan | GOLD PPO |
| Covered from | 26 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002743 | 23 Dec 2024 | 813.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 813.00 |