ELENA REYES
Dependent on policy B07M000638
Claims
3
Attributed to this person
Charged
814.00
Total submitted
Denied
194.31
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 | ELENA REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000638 |
| Date of birth | 11 Feb 1996 |
| 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 |
|---|---|---|---|---|---|
| CLM0002673 | 24 Jun 2025 | 141.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002672 | 21 Apr 2025 | 217.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002671 | 5 Apr 2025 | 456.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 194.31 |