LEILA REYES
Subscriber on policy B09M000860
Claims
3
Attributed to this person
Charged
850.00
Total submitted
Denied
321.00
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 | LEILA REYES |
| Role on the policy | Subscriber |
| Policy | B09M000860 |
| Date of birth | 14 Oct 1953 |
| Plan | GOLD PPO |
| Covered from | 11 Aug 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 |
|---|---|---|---|---|---|
| CLM0003645 | 20 Jun 2026 | 365.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003644 | 29 Jan 2025 | 321.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 321.00 |
| CLM0003646 | 15 Aug 2024 | 164.00 | NORTHSTAR MUTUAL | Not denied | — |