BRIAN REYES
Subscriber on policy B06M000541
Claims
2
Attributed to this person
Charged
754.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
137.10
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 | BRIAN REYES |
| Role on the policy | Subscriber |
| Policy | B06M000541 |
| Date of birth | 14 Oct 1955 |
| Plan | PLATINUM PPO |
| Covered from | 1 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 96.00 |
| CARC 1 · Deductible | 1 | 41.10 |
| Total | 137.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002411 | 11 Dec 2025 | 274.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002412 | 11 Apr 2024 | 480.00 | MERIDIAN HEALTH PLAN | Not denied | — |