HENRY REYES
Dependent on policy B01M000146
Claims
3
Attributed to this person
Charged
1,199.00
Total submitted
Denied
814.41
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 | HENRY REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000146 |
| Date of birth | 27 Jul 2001 |
| Plan | GOLD PPO |
| Covered from | 26 Oct 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 |
|---|---|---|---|---|---|
| CLM0000609 | 12 Jul 2026 | 766.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 766.00 |
| CLM0000610 | 21 Oct 2025 | 153.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 48.41 |
| CLM0000611 | 10 Dec 2024 | 280.00 | NORTHSTAR MUTUAL | Not denied | — |