MARCUS REYES
Subscriber on policy B02M000756
Claims
2
Attributed to this person
Charged
979.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
470.60
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 | MARCUS REYES |
| Role on the policy | Subscriber |
| Policy | B02M000756 |
| Date of birth | 17 Oct 1994 |
| Plan | PLATINUM PPO |
| Covered from | 25 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 470.60 |
| Total | 470.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003160 | 23 May 2025 | 255.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003161 | 2 Aug 2024 | 724.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |