LEILA REYES
Dependent on policy B05M000496
Claims
2
Attributed to this person
Charged
800.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
45.60
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 | LEILA REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000496 |
| Date of birth | 30 Dec 1983 |
| Plan | PLATINUM PPO |
| Covered from | 12 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 45.60 |
| Total | 45.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002131 | 24 Jun 2026 | 572.00 | CASCADE CARE | Not denied | — |
| CLM0002132 | 20 Sep 2025 | 228.00 | CASCADE CARE | Not denied | — |