DAVID REYES
Dependent on policy B04M000479
Claims
1
Attributed to this person
Charged
357.00
Total submitted
Denied
0.00
0 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 | DAVID REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000479 |
| Date of birth | 4 Mar 1953 |
| Plan | SILVER HMO |
| Covered from | 13 May 2024 |
| Covered to | 5 Feb 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002048 | 10 Jun 2024 | 357.00 | MERIDIAN HEALTH PLAN | Not denied | — |