DAVID REYES
Subscriber on policy B10M000453
Claims
3
Attributed to this person
Charged
2,210.00
Total submitted
Denied
470.00
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
| Field | Value |
|---|---|
| Name | DAVID REYES |
| Role on the policy | Subscriber |
| Policy | B10M000453 |
| Date of birth | 14 Aug 1992 |
| Plan | PLATINUM PPO |
| Covered from | 10 Jul 2024 |
| Covered to | 22 Nov 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 |
|---|---|---|---|---|---|
| CLM0001872 | 21 Oct 2024 | 852.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001874 | 1 Oct 2024 | 470.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 470.00 |
| CLM0001873 | 19 Jul 2024 | 888.00 | MERIDIAN HEALTH PLAN | Not denied | — |