RAVI ANDERSON
Subscriber on policy B05M000277
Claims
2
Attributed to this person
Charged
1,202.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
577.85
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 | RAVI ANDERSON |
| Role on the policy | Subscriber |
| Policy | B05M000277 |
| Date of birth | 23 Mar 1952 |
| Plan | SILVER HMO |
| Covered from | 8 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 577.85 |
| Total | 577.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001142 | 26 Apr 2026 | 889.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0001143 | 30 Oct 2025 | 313.00 | MERIDIAN HEALTH PLAN | Not denied | — |