MARCUS WILSON
Subscriber on policy B08M000147
Claims
2
Attributed to this person
Charged
1,315.00
Total submitted
Denied
261.46
1 denied claims
Patient responsibility
25.00
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 | MARCUS WILSON |
| Role on the policy | Subscriber |
| Policy | B08M000147 |
| Date of birth | 26 Aug 1976 |
| Plan | PLATINUM PPO |
| Covered from | 8 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000682 | 26 Jan 2026 | 662.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 261.46 |
| CLM0000683 | 16 Jul 2025 | 653.00 | NORTHSTAR MUTUAL | Not denied | — |