VICTOR REYES
Dependent on policy B09M000352
Claims
3
Attributed to this person
Charged
1,519.00
Total submitted
Denied
1,154.00
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 | VICTOR REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000352 |
| Date of birth | 8 Jan 1979 |
| Plan | PLATINUM PPO |
| Covered from | 14 Mar 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0001454 | 27 Nov 2025 | 365.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001455 | 6 Dec 2024 | 393.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 393.00 |
| CLM0001456 | 26 Nov 2024 | 761.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 761.00 |