YUSUF REYES
Subscriber on policy B03M000634
Claims
1
Attributed to this person
Charged
668.00
Total submitted
Denied
668.00
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 | YUSUF REYES |
| Role on the policy | Subscriber |
| Policy | B03M000634 |
| Date of birth | 10 May 1993 |
| Plan | GOLD PPO |
| Covered from | 24 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 |
|---|---|---|---|---|---|
| CLM0002613 | 30 Mar 2025 | 668.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 668.00 |