ELENA WILSON
Subscriber on policy B01M000604
Claims
3
Attributed to this person
Charged
2,024.00
Total submitted
Denied
192.85
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 | ELENA WILSON |
| Role on the policy | Subscriber |
| Policy | B01M000604 |
| Date of birth | 4 Apr 1988 |
| Plan | SILVER HMO |
| Covered from | 7 Aug 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 |
|---|---|---|---|---|---|
| CLM0002685 | 12 Dec 2025 | 832.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002684 | 29 Oct 2025 | 473.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 192.85 |
| CLM0002686 | 19 Aug 2025 | 719.00 | NORTHSTAR MUTUAL | Not denied | — |