SOFIA REYES
Subscriber on policy B04M000142
Claims
3
Attributed to this person
Charged
783.00
Total submitted
Denied
559.00
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 | SOFIA REYES |
| Role on the policy | Subscriber |
| Policy | B04M000142 |
| Date of birth | 10 Jun 1961 |
| Plan | PLATINUM PPO |
| Covered from | 16 Mar 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 |
|---|---|---|---|---|---|
| CLM0000650 | 16 Sep 2025 | 458.00 | CASCADE CARE | CARC 18 · DUPLICATE | 458.00 |
| CLM0000651 | 21 Sep 2024 | 224.00 | CASCADE CARE | Not denied | — |
| CLM0000652 | 24 Aug 2024 | 101.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 101.00 |