CARLA REYES
Dependent on policy B09M000018
Claims
2
Attributed to this person
Charged
918.00
Total submitted
Denied
918.00
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 | CARLA REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000018 |
| Date of birth | 14 Mar 1967 |
| Plan | PLATINUM PPO |
| Covered from | 11 Jan 2025 |
| Covered to | 3 May 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 |
|---|---|---|---|---|---|
| CLM0000070 | 9 Jan 2025 | 107.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 107.00 |
| CLM0000071 | 9 Jan 2025 | 811.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 811.00 |