TOMAS ANDERSON
Subscriber on policy B06M000690
Claims
2
Attributed to this person
Charged
1,083.00
Total submitted
Denied
442.00
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 | TOMAS ANDERSON |
| Role on the policy | Subscriber |
| Policy | B06M000690 |
| Date of birth | 26 Jul 1957 |
| Plan | GOLD PPO |
| Covered from | 1 May 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003078 | 22 Jun 2026 | 641.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003077 | 9 Jan 2026 | 442.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 442.00 |