KEVIN REYES
Subscriber on policy B06M000495
Claims
1
Attributed to this person
Charged
294.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
191.10
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 | B06M000495 |
| Date of birth | 26 Mar 1983 |
| Plan | PLATINUM PPO |
| Covered from | 26 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 191.10 |
| Total | 191.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002222 | 8 Feb 2026 | 294.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |