YUSUF REYES
Dependent on policy B07M000630
Claims
2
Attributed to this person
Charged
1,383.00
Total submitted
Denied
1,383.00
2 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 01 |
| Policy | B07M000630 |
| Date of birth | 17 Apr 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 |
|---|---|---|---|---|---|
| CLM0002641 | 18 May 2024 | 563.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 563.00 |
| CLM0002640 | 21 Feb 2024 | 820.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 820.00 |