ELENA REYES
Subscriber on policy B06M000100
Claims
3
Attributed to this person
Charged
533.00
Total submitted
Denied
207.00
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 | ELENA REYES |
| Role on the policy | Subscriber |
| Policy | B06M000100 |
| Date of birth | 13 Jun 1995 |
| Plan | GOLD PPO |
| Covered from | 15 Sep 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0000506 | 14 Dec 2025 | 207.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 207.00 |
| CLM0000507 | 18 Nov 2025 | 205.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000505 | 26 Sep 2024 | 121.00 | NORTHSTAR MUTUAL | Not denied | — |