AMARA REYES
Dependent on policy B04M000585
Claims
1
Attributed to this person
Charged
327.00
Total submitted
Denied
327.00
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 | AMARA REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000585 |
| Date of birth | 13 Dec 2018 |
| Plan | SILVER HMO |
| Covered from | 15 Feb 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 |
|---|---|---|---|---|---|
| CLM0002570 | 24 Mar 2025 | 327.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 327.00 |