JULIA REYES
Subscriber on policy B04M000135
Claims
2
Attributed to this person
Charged
976.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
94.80
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 | JULIA REYES |
| Role on the policy | Subscriber |
| Policy | B04M000135 |
| Date of birth | 11 Dec 1965 |
| Plan | GOLD PPO |
| Covered from | 5 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 94.80 |
| Total | 94.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000624 | 8 Dec 2025 | 344.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000623 | 16 Jan 2025 | 632.00 | MERIDIAN HEALTH PLAN | Not denied | — |