GRACE WILSON
Subscriber on policy B08M000287
Claims
1
Attributed to this person
Charged
677.00
Total submitted
Denied
0.00
0 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 | GRACE WILSON |
| Role on the policy | Subscriber |
| Policy | B08M000287 |
| Date of birth | 2 Mar 1989 |
| Plan | SILVER HMO |
| Covered from | 9 Nov 2024 |
| Covered to | 31 May 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 |
|---|---|---|---|---|---|
| CLM0001309 | 11 Jan 2025 | 677.00 | NORTHSTAR MUTUAL | Not denied | — |