IVAN PATEL
Dependent on policy B06M000762
Claims
2
Attributed to this person
Charged
1,079.00
Total submitted
Denied
523.12
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 | IVAN PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000762 |
| Date of birth | 22 Feb 1988 |
| Plan | SILVER HMO |
| Covered from | 15 Sep 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 |
|---|---|---|---|---|---|
| CLM0003375 | 27 Sep 2025 | 726.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 170.12 |
| CLM0003374 | 16 Aug 2024 | 353.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 353.00 |