RAVI REYES
Dependent on policy B01M000290
Claims
3
Attributed to this person
Charged
1,828.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
47.70
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 | RAVI REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000290 |
| Date of birth | 27 Feb 2018 |
| Plan | PLATINUM PPO |
| Covered from | 31 May 2025 |
| Covered to | 3 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 47.70 |
| Total | 47.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001273 | 20 Aug 2025 | 794.00 | CASCADE CARE | Not denied | — |
| CLM0001274 | 18 Jul 2025 | 318.00 | CASCADE CARE | Not denied | — |
| CLM0001275 | 8 Jun 2025 | 716.00 | CASCADE CARE | Not denied | — |