PRIYA REYES
Dependent on policy B08M000060
Claims
3
Attributed to this person
Charged
1,568.00
Total submitted
Denied
828.00
1 denied claims
Patient responsibility
119.20
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 | PRIYA REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000060 |
| Date of birth | 18 Aug 1967 |
| Plan | PLATINUM PPO |
| Covered from | 23 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 119.20 |
| Total | 119.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000279 | 25 Feb 2025 | 144.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000280 | 19 Feb 2025 | 596.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000281 | 20 Jan 2025 | 828.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 828.00 |