BRIAN REYES
Subscriber on policy B03M000106
Claims
1
Attributed to this person
Charged
327.00
Total submitted
Denied
327.00
1 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 | BRIAN REYES |
| Role on the policy | Subscriber |
| Policy | B03M000106 |
| Date of birth | 26 Sep 1997 |
| Plan | GOLD PPO |
| Covered from | 3 Aug 2024 |
| Covered to | 29 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000425 | 28 Mar 2025 | 327.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 327.00 |