OMAR REYES
Dependent on policy B03M000272
Claims
1
Attributed to this person
Charged
850.00
Total submitted
Denied
262.26
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 | OMAR REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000272 |
| Date of birth | 11 Apr 1998 |
| Plan | SILVER HMO |
| Covered from | 5 Jul 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 |
|---|---|---|---|---|---|
| CLM0001090 | 21 Aug 2025 | 850.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 262.26 |