SOFIA PATEL
Dependent on policy B05M000395
Claims
2
Attributed to this person
Charged
490.00
Total submitted
Denied
77.00
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 | SOFIA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000395 |
| Date of birth | 26 May 2010 |
| Plan | SILVER HMO |
| Covered from | 27 Sep 2024 |
| Covered to | 3 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 |
|---|---|---|---|---|---|
| CLM0001687 | 18 Apr 2025 | 77.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 77.00 |
| CLM0001688 | 25 Mar 2025 | 413.00 | MERIDIAN HEALTH PLAN | Not denied | — |