RAVI ANDERSON
Dependent on policy B01M000700
Claims
1
Attributed to this person
Charged
167.00
Total submitted
Denied
167.00
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 | RAVI ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000700 |
| Date of birth | 11 Apr 1974 |
| Plan | SILVER HMO |
| Covered from | 4 Jun 2025 |
| Covered to | 11 Aug 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 |
|---|---|---|---|---|---|
| CLM0003131 | 23 May 2025 | 167.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 167.00 |