TOMAS REYES
Subscriber on policy B09M000405
Claims
1
Attributed to this person
Charged
371.00
Total submitted
Denied
0.00
0 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 | TOMAS REYES |
| Role on the policy | Subscriber |
| Policy | B09M000405 |
| Date of birth | 15 Sep 1977 |
| Plan | GOLD PPO |
| Covered from | 2 Apr 2025 |
| Covered to | 7 Dec 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 |
|---|---|---|---|---|---|
| CLM0001685 | 15 Apr 2025 | 371.00 | CASCADE CARE | Not denied | — |