FIONA REYES
Dependent on policy B06M000841
Claims
2
Attributed to this person
Charged
760.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
33.00
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 01 |
| Policy | B06M000841 |
| Date of birth | 5 Jul 1959 |
| Plan | GOLD PPO |
| Covered from | 14 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 33.00 |
| Total | 33.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003677 | 28 Mar 2026 | 540.00 | CASCADE CARE | Not denied | — |
| CLM0003676 | 10 Jul 2025 | 220.00 | CASCADE CARE | Not denied | — |