IVAN REYES
Dependent on policy B05M000457
Claims
1
Attributed to this person
Charged
625.00
Total submitted
Denied
625.00
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 | IVAN REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000457 |
| Date of birth | 6 Mar 1974 |
| Plan | BRONZE EPO |
| Covered from | 17 Nov 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 |
|---|---|---|---|---|---|
| CLM0001915 | 16 May 2026 | 625.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 625.00 |