DAVID WILSON
Dependent on policy B05M000896
Claims
1
Attributed to this person
Charged
596.00
Total submitted
Denied
596.00
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 | DAVID WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000896 |
| Date of birth | 15 Oct 1991 |
| Plan | PLATINUM PPO |
| Covered from | 9 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003815 | 26 Apr 2026 | 596.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 596.00 |