HENRY REYES
Subscriber on policy B03M000146
Claims
3
Attributed to this person
Charged
883.00
Total submitted
Denied
812.00
2 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 | HENRY REYES |
| Role on the policy | Subscriber |
| Policy | B03M000146 |
| Date of birth | 18 Dec 1978 |
| Plan | GOLD PPO |
| Covered from | 7 Apr 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 |
|---|---|---|---|---|---|
| CLM0000596 | 28 Jan 2026 | 374.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 374.00 |
| CLM0000594 | 9 May 2024 | 71.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000595 | 18 Mar 2024 | 438.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 438.00 |