WENDY WILSON
Subscriber on policy B06M000338
Claims
1
Attributed to this person
Charged
322.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
209.30
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 | WENDY WILSON |
| Role on the policy | Subscriber |
| Policy | B06M000338 |
| Date of birth | 24 Jun 1987 |
| Plan | GOLD PPO |
| Covered from | 21 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 209.30 |
| Total | 209.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001524 | 13 Mar 2026 | 322.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |