LEILA REYES
Dependent on policy B10M000356
Claims
1
Attributed to this person
Charged
268.00
Total submitted
Denied
268.00
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 | Dependent · relationship 01 |
| Policy | B10M000356 |
| Date of birth | 20 Nov 1969 |
| Plan | BRONZE EPO |
| Covered from | 8 Jun 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 |
|---|---|---|---|---|---|
| CLM0001487 | 21 Dec 2025 | 268.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 268.00 |