FIONA REYES
Dependent on policy B06M000346
Claims
1
Attributed to this person
Charged
422.00
Total submitted
Denied
422.00
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 | FIONA REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000346 |
| Date of birth | 9 Apr 1973 |
| Plan | BRONZE EPO |
| Covered from | 18 May 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 |
|---|---|---|---|---|---|
| CLM0001575 | 8 May 2025 | 422.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 422.00 |