AMARA REYES
Subscriber on policy B10M000615
Claims
1
Attributed to this person
Charged
666.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
50.00
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 | AMARA REYES |
| Role on the policy | Subscriber |
| Policy | B10M000615 |
| Date of birth | 4 Aug 1981 |
| Plan | BRONZE EPO |
| Covered from | 2 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002565 | 29 Sep 2025 | 666.00 | MERIDIAN HEALTH PLAN | Not denied | — |