LEILA REYES
Dependent on policy B03M000624
Claims
1
Attributed to this person
Charged
431.00
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 | LEILA REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000624 |
| Date of birth | 27 Sep 1968 |
| Plan | SILVER HMO |
| Covered from | 17 Mar 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 |
|---|---|---|---|---|---|
| CLM0002578 | 5 Sep 2025 | 431.00 | NORTHSTAR MUTUAL | Not denied | — |