RAVI REYES
Dependent on policy B01M000150
Claims
3
Attributed to this person
Charged
1,481.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
347.10
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 | RAVI REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000150 |
| Date of birth | 8 May 1952 |
| Plan | SILVER HMO |
| Covered from | 6 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 347.10 |
| Total | 347.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000629 | 9 Jun 2025 | 574.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000631 | 7 Jun 2025 | 373.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000630 | 4 Jan 2025 | 534.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |