ELENA REYES
Subscriber on policy B07M000300
Claims
2
Attributed to this person
Charged
1,257.00
Total submitted
Denied
1,257.00
2 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 | ELENA REYES |
| Role on the policy | Subscriber |
| Policy | B07M000300 |
| Date of birth | 29 Nov 1980 |
| Plan | BRONZE EPO |
| Covered from | 23 Mar 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 |
|---|---|---|---|---|---|
| CLM0001296 | 22 Dec 2025 | 570.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 570.00 |
| CLM0001295 | 15 Jun 2025 | 687.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 687.00 |