GRACE REYES
Subscriber on policy B01M000150
Claims
1
Attributed to this person
Charged
660.00
Total submitted
Denied
660.00
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 | GRACE REYES |
| Role on the policy | Subscriber |
| Policy | B01M000150 |
| Date of birth | 30 Jun 1958 |
| Plan | SILVER HMO |
| Covered from | 6 Nov 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 |
|---|---|---|---|---|---|
| CLM0000628 | 27 Jan 2026 | 660.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 660.00 |