GRACE REYES
Dependent on policy B07M000635
Claims
3
Attributed to this person
Charged
1,533.00
Total submitted
Denied
0.00
0 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 | GRACE REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000635 |
| Date of birth | 2 May 2000 |
| Plan | PLATINUM PPO |
| Covered from | 7 Feb 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 |
|---|---|---|---|---|---|
| CLM0002657 | 14 Aug 2025 | 91.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002656 | 23 May 2025 | 878.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002655 | 8 Apr 2025 | 564.00 | NORTHSTAR MUTUAL | Not denied | — |