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Manage Claims Flipbook PDF
Manage Claims
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Filter the claims Member: BRIANA (
Claim Type:
Dates:
Me
Apply
Last 180
Date
Member
Provider
Bill Amount
06/29/20
BRIANA (You)
ELIZABETH LENER
$170.00
$0.00
$0
06/29/20
BRIANA (You)
ELIZABETH LENER
$170.00
$98.96
$0 View claim details
06/17/20
BRIANA (You)
MISSION HOSPITAL REGIONAL $12,257.00 MEDICAL CENTER
$8,501.46
$0 View claim details
06/17/20
BRIANA (You)
MISSION HOS REGIONAL
$12,257.00
$0.00
$0
06/09/20
BRIANA (You)
MICHAEL JAKOBSEN
$790.00
$354.73
$0 View claim details
06/09/20
BRIANA (You)
MICHAEL JAKOBSEN
$790.00
$0.00
$0
06/08/20
BRIANA (You)
DARIUS VELEAS
$339.00
$0.00
$0
06/01/20
BRIANA (You)
MADINETH MUY
$220.00
$0.00
$0
06/01/20
BRIANA (You)
MISSION HOS REGIONAL
$37,334.00
$0.00
$0
06/01/20
BRIANA (You)
MADINETH MUY
$220.00
$116.86
$28.48 View claim details
Plan Paid
Your Responsibility
Member
Provider
Bill Amount
Plan Paid
06/01/20
BRIANA (You)
MISSION HOSPITAL REGIONAL $37,334.00 MEDICAL CENTER
$18,528.87
$0 View claim details
05/28/20
BRIANA (You)
MISSION HOS REGIONAL
$0.00
$0
05/28/20
BRIANA (You)
MISSION HOSPITAL REGIONAL $2,881.00 MEDICAL CENTER
$1,978.26
$20.00 View claim details
05/09/20
BRIANA (You)
BRIAN CHOI
$300.00
$0.00
$0
05/09/20
BRIANA (You)
BRIAN CHOI
$300.00
$0.00
$0
05/09/20
BRIANA (You)
BRIAN CHOI
$300.00
$0.00
$300.00 View claim details
05/09/20
BRIANA (You)
BRIAN CHOI
$300.00
$0.00
$300.00 View claim details
05/04/20
BRIANA (You)
THOMAS GRAYDEN $925.00
$0.00
$0
05/04/20
BRIANA (You)
THOMAS GRAYDEN $925.00
$574.00
$351.00 View claim details
05/03/20
BRIANA (You)
MISSION HERITAGE $159.00 MEDICAL GROUP
$76.64
$8.52 View claim details
05/03/20
BRIANA (You)
AFSHIN DOUST
$159.00
$0.00
$0
05/02/20
BRIANA (You)
SASAN GHAFFARI
$30.00
$0.00
$0
05/02/20
BRIANA (You)
GUISOU MAHMOUD
$1,292.00
$0.00
$0
05/02/20
BRIANA (You)
MISSION HOS REGIONAL
$35,626.97
$0.00
$0
Date
$2,881.00
Your Responsibility
Date
Member
Provider
Bill Amount
Plan Paid
Your Responsibility
05/02/20
BRIANA (You)
SASAN GHAFFARI
$30.00
$0.00
$0
05/02/20
BRIANA (You)
MISSION VIEJO EMERGENCY MEDICAL ASSOCIATES
$1,292.00
$1,158.00
$134.00 View claim details
05/02/20
BRIANA (You)
MISSION HOSPITAL REGIONAL $35,626.97 MEDICAL CENTER
$22,239.77
$2,471.09 View claim details
05/02/20
BRIANA (You)
MISSION HOSPITAL REGIONAL $3,742.00 MEDICAL CENTER
$2,595.45
$0 View claim details
05/02/20
BRIANA (You)
SASAN GHAFFARI
$30.00
$0.00
$0 View claim details
05/02/20
BRIANA (You)
SASAN GHAFFARI
$30.00
$8.12
$0.90 View claim details
05/02/20
BRIANA (You)
PAMELA RENK
$3,325.00
$1,400.00
$1,925.00 View claim details
05/02/20
BRIANA (You)
MISSION HOS REGIONAL
$3,742.00
$0.00
$0
03/10/20
BRIANA (You)
LABCORP
$156.50
$53.65
$5.97 View claim details
03/10/20
BRIANA (You)
LABCORP RARITAN
$156.50
$0.00
$0
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