LEILA REYES
Subscriber on policy B02M000586
Claims
3
Attributed to this person
Charged
1,329.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
68.40
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 | Subscriber |
| Policy | B02M000586 |
| Date of birth | 24 Jul 1972 |
| Plan | GOLD PPO |
| Covered from | 29 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 68.40 |
| Total | 68.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002468 | 11 Aug 2026 | 239.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002467 | 8 Jun 2026 | 342.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002466 | 23 Feb 2025 | 748.00 | NORTHSTAR MUTUAL | Not denied | — |