NADIA REYES
Subscriber on policy B02M000774
Claims
3
Attributed to this person
Charged
551.00
Total submitted
Denied
409.00
3 denied claims
Patient responsibility
92.30
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 | B02M000774 |
| Date of birth | 13 Aug 1955 |
| Plan | PLATINUM PPO |
| Covered from | 13 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 92.30 |
| Total | 92.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003234 | 15 May 2026 | 142.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0003233 | 15 Oct 2025 | 154.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 154.00 |
| CLM0003232 | 26 Apr 2025 | 255.00 | CASCADE CARE | CARC 96 · NON_COVERED | 255.00 |