CARLA REYES
Subscriber on policy B06M000028
Claims
2
Attributed to this person
Charged
919.00
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 | CARLA REYES |
| Role on the policy | Subscriber |
| Policy | B06M000028 |
| Date of birth | 2 Aug 2002 |
| Plan | BRONZE EPO |
| Covered from | 3 Oct 2024 |
| Covered to | 5 Apr 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 |
|---|---|---|---|---|---|
| CLM0000169 | 5 Mar 2025 | 123.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000168 | 6 Nov 2024 | 796.00 | NORTHSTAR MUTUAL | Not denied | — |