LEILA PATEL
Dependent on policy B06M000348
Claims
2
Attributed to this person
Charged
1,453.00
Total submitted
Denied
806.00
1 denied claims
Patient responsibility
97.05
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 | LEILA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000348 |
| Date of birth | 19 Feb 1984 |
| Plan | PLATINUM PPO |
| Covered from | 8 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 97.05 |
| Total | 97.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001579 | 29 Sep 2025 | 806.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 806.00 |
| CLM0001580 | 6 Feb 2025 | 647.00 | MERIDIAN HEALTH PLAN | Not denied | — |