ELENA REYES
Subscriber on policy B07M000630
Claims
1
Attributed to this person
Charged
680.00
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 | ELENA REYES |
| Role on the policy | Subscriber |
| Policy | B07M000630 |
| Date of birth | 20 Jun 1978 |
| Plan | BRONZE EPO |
| Covered from | 7 Feb 2024 |
| Covered to | 11 Apr 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002639 | 19 Mar 2024 | 680.00 | CASCADE CARE | Not denied | — |