OMAR REYES
Dependent on policy B01M000023
Claims
2
Attributed to this person
Charged
879.00
Total submitted
Denied
448.00
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 | OMAR REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000023 |
| Date of birth | 16 Jul 2013 |
| Plan | SILVER HMO |
| Covered from | 6 Oct 2024 |
| Covered to | 15 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000089 | 29 Mar 2025 | 448.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 448.00 |
| CLM0000090 | 25 Feb 2025 | 431.00 | CASCADE CARE | Not denied | — |