IVAN REYES
Subscriber on policy B08M000411
Claims
2
Attributed to this person
Charged
955.00
Total submitted
Denied
955.00
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 | IVAN REYES |
| Role on the policy | Subscriber |
| Policy | B08M000411 |
| Date of birth | 30 Sep 1982 |
| Plan | GOLD PPO |
| Covered from | 11 May 2024 |
| Covered to | 21 Jul 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001893 | 19 Aug 2024 | 736.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 736.00 |
| CLM0001894 | 10 Aug 2024 | 219.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 219.00 |