VICTOR REYES
Subscriber on policy B10M000594
Claims
1
Attributed to this person
Charged
532.00
Total submitted
Denied
262.60
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 | VICTOR REYES |
| Role on the policy | Subscriber |
| Policy | B10M000594 |
| Date of birth | 6 Mar 1970 |
| Plan | PLATINUM PPO |
| Covered from | 19 Jan 2024 |
| Covered to | 25 Jun 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002456 | 24 Feb 2024 | 532.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 262.60 |