VICTOR PATEL
Dependent on policy B05M000193
Claims
1
Attributed to this person
Charged
300.00
Total submitted
Denied
111.06
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 | VICTOR PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000193 |
| Date of birth | 15 Nov 1985 |
| Plan | GOLD PPO |
| Covered from | 5 Mar 2025 |
| Covered to | 6 May 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 |
|---|---|---|---|---|---|
| CLM0000812 | 22 Apr 2025 | 300.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 111.06 |