TOMAS REYES
Subscriber on policy B08M000416
Claims
3
Attributed to this person
Charged
1,544.00
Total submitted
Denied
1,308.00
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 | TOMAS REYES |
| Role on the policy | Subscriber |
| Policy | B08M000416 |
| Date of birth | 16 Sep 1957 |
| Plan | SILVER HMO |
| Covered from | 12 Mar 2024 |
| Covered to | 8 Oct 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 |
|---|---|---|---|---|---|
| CLM0001918 | 6 Nov 2024 | 236.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001917 | 28 Oct 2024 | 692.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 692.00 |
| CLM0001916 | 21 Feb 2024 | 616.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 616.00 |