DAVID REYES
Dependent on policy B01M000290
Claims
2
Attributed to this person
Charged
664.00
Total submitted
Denied
205.00
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 | DAVID REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000290 |
| Date of birth | 3 Sep 2010 |
| Plan | PLATINUM PPO |
| Covered from | 31 May 2025 |
| Covered to | 3 Sep 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 |
|---|---|---|---|---|---|
| CLM0001272 | 19 Sep 2025 | 205.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 205.00 |
| CLM0001271 | 14 Jul 2025 | 459.00 | CASCADE CARE | Not denied | — |