AMARA REYES
Dependent on policy B03M000373
Claims
1
Attributed to this person
Charged
143.00
Total submitted
Denied
70.56
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 | AMARA REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000373 |
| Date of birth | 22 May 1966 |
| Plan | PLATINUM PPO |
| Covered from | 30 Apr 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 |
|---|---|---|---|---|---|
| CLM0001516 | 19 Jul 2025 | 143.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 70.56 |