ZARA REYES
Dependent on policy B05M000815
Claims
3
Attributed to this person
Charged
1,777.00
Total submitted
Denied
711.47
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 | ZARA REYES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000815 |
| Date of birth | 14 Oct 2009 |
| Plan | BRONZE EPO |
| Covered from | 6 Jul 2024 |
| Covered to | 9 Dec 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003466 | 2 Feb 2025 | 557.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 557.00 |
| CLM0003468 | 29 Aug 2024 | 478.00 | CASCADE CARE | CARC 11 · CODING | 154.47 |
| CLM0003467 | 23 Aug 2024 | 742.00 | CASCADE CARE | Not denied | — |