PRIYA ANDERSON
Dependent on policy B06M000591
Claims
2
Attributed to this person
Charged
712.00
Total submitted
Denied
59.70
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 | PRIYA ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000591 |
| Date of birth | 8 Jan 2004 |
| Plan | GOLD PPO |
| Covered from | 24 May 2024 |
| Covered to | 17 Nov 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 |
|---|---|---|---|---|---|
| CLM0002652 | 13 Sep 2024 | 159.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 59.70 |
| CLM0002653 | 12 Jul 2024 | 553.00 | NORTHSTAR MUTUAL | Not denied | — |