YUSUF WILSON
Dependent on policy B06M000150
Claims
3
Attributed to this person
Charged
1,471.00
Total submitted
Denied
1,032.46
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 | YUSUF WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000150 |
| Date of birth | 12 Feb 1988 |
| Plan | SILVER HMO |
| Covered from | 8 Oct 2024 |
| Covered to | 28 May 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000735 | 13 Jan 2025 | 76.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000737 | 3 Jan 2025 | 808.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 808.00 |
| CLM0000736 | 4 Nov 2024 | 587.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 224.46 |