IVAN REYES
Subscriber on policy B03M000464
Claims
3
Attributed to this person
Charged
1,252.00
Total submitted
Denied
323.97
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 | IVAN REYES |
| Role on the policy | Subscriber |
| Policy | B03M000464 |
| Date of birth | 6 Sep 1996 |
| Plan | SILVER HMO |
| Covered from | 9 Feb 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001922 | 20 Jun 2026 | 131.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 131.00 |
| CLM0001924 | 26 Sep 2025 | 526.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001923 | 7 Sep 2025 | 595.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 192.97 |