CARLA REYES
Dependent on policy B02M000243
Claims
2
Attributed to this person
Charged
986.00
Total submitted
Denied
151.00
1 denied claims
Patient responsibility
167.00
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 | CARLA REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000243 |
| Date of birth | 31 Jul 1967 |
| Plan | SILVER HMO |
| Covered from | 12 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 167.00 |
| Total | 167.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001062 | 18 Jan 2026 | 151.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 151.00 |
| CLM0001061 | 6 Aug 2025 | 835.00 | CASCADE CARE | Not denied | — |