OMAR REYES
Dependent on policy B04M000089
Claims
2
Attributed to this person
Charged
965.00
Total submitted
Denied
476.00
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 | OMAR REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000089 |
| Date of birth | 6 Oct 1972 |
| Plan | PLATINUM PPO |
| Covered from | 27 Jun 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 |
|---|---|---|---|---|---|
| CLM0000400 | 12 Mar 2026 | 476.00 | CASCADE CARE | CARC 18 · DUPLICATE | 476.00 |
| CLM0000399 | 8 Oct 2025 | 489.00 | CASCADE CARE | Not denied | — |