KEVIN REYES
Subscriber on policy B06M000470
Claims
2
Attributed to this person
Charged
1,652.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
25.00
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 | KEVIN REYES |
| Role on the policy | Subscriber |
| Policy | B06M000470 |
| Date of birth | 17 Oct 1984 |
| Plan | SILVER HMO |
| Covered from | 9 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002119 | 5 Jun 2026 | 764.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002118 | 5 Mar 2025 | 888.00 | NORTHSTAR MUTUAL | Not denied | — |