NADIA REYES
Subscriber on policy B02M000557
Claims
2
Attributed to this person
Charged
313.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
40.95
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 | NADIA REYES |
| Role on the policy | Subscriber |
| Policy | B02M000557 |
| Date of birth | 15 Jan 1992 |
| Plan | SILVER HMO |
| Covered from | 12 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 40.95 |
| Total | 40.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002351 | 9 Sep 2025 | 250.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002352 | 8 Apr 2024 | 63.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 0.00 |