UMA WILSON
Subscriber on policy B04M000864
Claims
1
Attributed to this person
Charged
299.00
Total submitted
Denied
299.00
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 | UMA WILSON |
| Role on the policy | Subscriber |
| Policy | B04M000864 |
| Date of birth | 21 Apr 1966 |
| Plan | GOLD PPO |
| Covered from | 18 Sep 2024 |
| Covered to | 29 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003731 | 8 Sep 2024 | 299.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 299.00 |