ZARA REYES
Subscriber on policy B03M000538
Claims
3
Attributed to this person
Charged
697.00
Total submitted
Denied
276.34
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 | ZARA REYES |
| Role on the policy | Subscriber |
| Policy | B03M000538 |
| Date of birth | 21 Sep 2004 |
| Plan | PLATINUM PPO |
| Covered from | 26 Aug 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 |
|---|---|---|---|---|---|
| CLM0002210 | 19 Apr 2025 | 101.00 | CASCADE CARE | Not denied | — |
| CLM0002208 | 17 Feb 2025 | 439.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 119.34 |
| CLM0002209 | 13 Aug 2024 | 157.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 157.00 |