KEVIN REYES
Dependent on policy B07M000300
Claims
1
Attributed to this person
Charged
777.00
Total submitted
Denied
215.49
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 | KEVIN REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000300 |
| Date of birth | 22 Feb 1981 |
| 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 |
|---|---|---|---|---|---|
| CLM0001297 | 26 Jun 2026 | 777.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 215.49 |