YUSUF REYES
Dependent on policy B01M000023
Claims
3
Attributed to this person
Charged
1,434.00
Total submitted
Denied
483.00
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 | YUSUF REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000023 |
| Date of birth | 17 Jan 2006 |
| 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 |
|---|---|---|---|---|---|
| CLM0000092 | 20 Dec 2024 | 483.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 483.00 |
| CLM0000093 | 6 Dec 2024 | 670.00 | CASCADE CARE | Not denied | — |
| CLM0000091 | 17 Oct 2024 | 281.00 | CASCADE CARE | Not denied | — |