TOMAS ANDERSON
Dependent on policy B05M000723
Claims
3
Attributed to this person
Charged
915.00
Total submitted
Denied
86.00
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 ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000723 |
| Date of birth | 11 Oct 1980 |
| Plan | SILVER HMO |
| Covered from | 6 Jun 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 |
|---|---|---|---|---|---|
| CLM0003098 | 3 Aug 2026 | 468.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003097 | 28 Jun 2025 | 86.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 86.00 |
| CLM0003099 | 16 Feb 2025 | 361.00 | MERIDIAN HEALTH PLAN | Not denied | — |