TOMAS REYES
Dependent on policy B10M000303
Claims
3
Attributed to this person
Charged
1,150.00
Total submitted
Denied
710.71
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 | Dependent · relationship 01 |
| Policy | B10M000303 |
| Date of birth | 28 Jun 1955 |
| Plan | GOLD PPO |
| Covered from | 28 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001268 | 3 May 2025 | 133.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001267 | 25 Jan 2025 | 549.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 242.71 |
| CLM0001269 | 30 Dec 2024 | 468.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 468.00 |