CARLA REYES
Subscriber on policy B01M000154
Claims
2
Attributed to this person
Charged
773.00
Total submitted
Denied
773.00
2 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 | CARLA REYES |
| Role on the policy | Subscriber |
| Policy | B01M000154 |
| Date of birth | 20 Apr 1950 |
| Plan | BRONZE EPO |
| Covered from | 29 Sep 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 |
|---|---|---|---|---|---|
| CLM0000647 | 15 Oct 2024 | 594.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 594.00 |
| CLM0000648 | 1 Sep 2024 | 179.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 179.00 |