X12 Ingest & Denial Analytics

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Members›policy B08M000182›TOMAS REYES

TOMAS REYES

Subscriber on policy B08M000182

Claims
3
Attributed to this person
Charged
1,144.00
Total submitted
Denied
258.00
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

FieldValue
NameTOMAS REYES
Role on the policySubscriber
PolicyB08M000182
Date of birth6 May 1995
PlanGOLD PPO
Covered from12 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000081525 Feb 2026258.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE258.00
CLM00008142 Nov 2025681.00MERIDIAN HEALTH PLANNot denied—
CLM000081327 Sep 2025205.00MERIDIAN HEALTH PLANNot denied—