VICTOR REYES
Dependent on policy B01M000575
Claims
2
Attributed to this person
Charged
504.00
Total submitted
Denied
416.00
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 | VICTOR REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000575 |
| Date of birth | 13 Mar 1981 |
| Plan | BRONZE EPO |
| Covered from | 24 Jun 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 |
|---|---|---|---|---|---|
| CLM0002563 | 22 Jan 2026 | 416.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 416.00 |
| CLM0002562 | 5 Jul 2025 | 88.00 | NORTHSTAR MUTUAL | Not denied | — |