GRACE REYES
Subscriber on policy B06M000011
Claims
3
Attributed to this person
Charged
973.00
Total submitted
Denied
387.00
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 | GRACE REYES |
| Role on the policy | Subscriber |
| Policy | B06M000011 |
| Date of birth | 23 Feb 1979 |
| Plan | SILVER HMO |
| Covered from | 10 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000063 | 4 Jan 2026 | 387.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 387.00 |
| CLM0000061 | 27 May 2025 | 254.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000062 | 13 May 2025 | 332.00 | NORTHSTAR MUTUAL | Not denied | — |