JULIA REYES
Dependent on policy B03M000869
Claims
3
Attributed to this person
Charged
1,368.00
Total submitted
Denied
164.00
1 denied claims
Patient responsibility
180.60
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 | JULIA REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000869 |
| Date of birth | 28 Nov 1984 |
| Plan | GOLD PPO |
| Covered from | 18 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 2 | 180.60 |
| Total | 180.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003766 | 2 Jun 2026 | 164.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 164.00 |
| CLM0003765 | 13 May 2025 | 561.00 | CASCADE CARE | Not denied | — |
| CLM0003767 | 23 Feb 2025 | 643.00 | CASCADE CARE | Not denied | — |