VICTOR REYES
Subscriber on policy B03M000013
Claims
3
Attributed to this person
Charged
1,538.00
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 | VICTOR REYES |
| Role on the policy | Subscriber |
| Policy | B03M000013 |
| Date of birth | 12 Dec 1953 |
| Plan | SILVER HMO |
| Covered from | 23 Mar 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000067 | 16 Jul 2026 | 126.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000065 | 10 Aug 2025 | 663.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000066 | 15 Jun 2025 | 749.00 | MERIDIAN HEALTH PLAN | Not denied | — |