JULIA REYES
Subscriber on policy B04M000129
Claims
3
Attributed to this person
Charged
1,679.00
Total submitted
Denied
660.00
1 denied claims
Patient responsibility
34.20
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 | Subscriber |
| Policy | B04M000129 |
| Date of birth | 12 May 1986 |
| Plan | BRONZE EPO |
| Covered from | 29 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 34.20 |
| Total | 34.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000592 | 8 Feb 2026 | 228.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000594 | 13 Aug 2025 | 660.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 660.00 |
| CLM0000593 | 22 May 2025 | 791.00 | NORTHSTAR MUTUAL | Not denied | — |