RAVI REYES
Subscriber on policy B07M000638
Claims
3
Attributed to this person
Charged
1,463.00
Total submitted
Denied
75.84
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 | RAVI REYES |
| Role on the policy | Subscriber |
| Policy | B07M000638 |
| Date of birth | 5 Jul 1972 |
| Plan | PLATINUM PPO |
| Covered from | 12 Feb 2025 |
| Covered to | 6 Aug 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002667 | 4 May 2025 | 344.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 75.84 |
| CLM0002666 | 28 Apr 2025 | 650.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002668 | 14 Feb 2025 | 469.00 | MERIDIAN HEALTH PLAN | Not denied | — |