ZARA REYES
Subscriber on policy B03M000107
Claims
1
Attributed to this person
Charged
372.00
Total submitted
Denied
0.00
0 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 | ZARA REYES |
| Role on the policy | Subscriber |
| Policy | B03M000107 |
| Date of birth | 17 Sep 1958 |
| Plan | GOLD PPO |
| Covered from | 18 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000428 | 30 Aug 2024 | 372.00 | NORTHSTAR MUTUAL | Not denied | — |