DAVID REYES
Subscriber on policy B01M000601
Claims
3
Attributed to this person
Charged
867.00
Total submitted
Denied
528.00
1 denied claims
Patient responsibility
32.00
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 | Subscriber |
| Policy | B01M000601 |
| Date of birth | 19 Jul 1958 |
| Plan | PLATINUM PPO |
| Covered from | 28 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 32.00 |
| Total | 32.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002673 | 25 Mar 2026 | 179.00 | CASCADE CARE | Not denied | — |
| CLM0002672 | 2 Sep 2025 | 528.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 528.00 |
| CLM0002674 | 27 Dec 2024 | 160.00 | CASCADE CARE | Not denied | — |