IVAN REYES
Subscriber on policy B07M000153
Claims
1
Attributed to this person
Charged
731.00
Total submitted
Denied
209.43
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 | IVAN REYES |
| Role on the policy | Subscriber |
| Policy | B07M000153 |
| Date of birth | 10 Jul 1950 |
| Plan | GOLD PPO |
| Covered from | 1 Feb 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 |
|---|---|---|---|---|---|
| CLM0000626 | 16 Jul 2025 | 731.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 209.43 |