GRACE REYES
Dependent on policy B10M000067
Claims
3
Attributed to this person
Charged
1,896.00
Total submitted
Denied
740.00
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 | GRACE REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000067 |
| Date of birth | 2 Aug 1961 |
| Plan | GOLD PPO |
| Covered from | 1 Jun 2025 |
| Covered to | 22 Feb 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000270 | 8 Jan 2026 | 673.00 | CASCADE CARE | Not denied | — |
| CLM0000272 | 21 Jul 2025 | 740.00 | CASCADE CARE | CARC 11 · CODING | 740.00 |
| CLM0000271 | 9 Jun 2025 | 483.00 | CASCADE CARE | Not denied | — |