LEILA WILSON
Dependent on policy B08M000533
Claims
2
Attributed to this person
Charged
1,467.00
Total submitted
Denied
785.00
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 | LEILA WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000533 |
| Date of birth | 1 Oct 2022 |
| Plan | BRONZE EPO |
| Covered from | 30 Apr 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 |
|---|---|---|---|---|---|
| CLM0002440 | 17 May 2026 | 785.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 785.00 |
| CLM0002441 | 14 May 2026 | 682.00 | NORTHSTAR MUTUAL | Not denied | — |