BRIAN ANDERSON
Dependent on policy B06M000364
Claims
1
Attributed to this person
Charged
296.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
59.20
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 | BRIAN ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000364 |
| Date of birth | 7 May 1963 |
| Plan | BRONZE EPO |
| Covered from | 6 Apr 2024 |
| Covered to | 7 Sep 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 59.20 |
| Total | 59.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001657 | 20 Oct 2024 | 296.00 | MERIDIAN HEALTH PLAN | Not denied | — |