AMARA REYES
Dependent on policy B01M000153
Claims
3
Attributed to this person
Charged
905.00
Total submitted
Denied
202.42
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 | AMARA REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000153 |
| Date of birth | 30 Sep 1957 |
| Plan | GOLD PPO |
| Covered from | 12 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 |
|---|---|---|---|---|---|
| CLM0000644 | 1 Nov 2025 | 181.00 | CASCADE CARE | Not denied | — |
| CLM0000645 | 24 Aug 2025 | 278.00 | CASCADE CARE | Not denied | — |
| CLM0000643 | 8 Jul 2025 | 446.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 202.42 |