AMARA REYES
Dependent on policy B10M000639
Claims
2
Attributed to this person
Charged
764.00
Total submitted
Denied
764.00
2 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 | AMARA REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000639 |
| Date of birth | 11 Jan 1980 |
| Plan | SILVER HMO |
| Covered from | 31 Oct 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 |
|---|---|---|---|---|---|
| CLM0002656 | 9 May 2025 | 622.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 622.00 |
| CLM0002657 | 30 Mar 2025 | 142.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 142.00 |