CARLA PATEL
Subscriber on policy B08M000777
Claims
2
Attributed to this person
Charged
942.00
Total submitted
Denied
217.27
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 | CARLA PATEL |
| Role on the policy | Subscriber |
| Policy | B08M000777 |
| Date of birth | 4 Aug 1962 |
| Plan | PLATINUM PPO |
| Covered from | 16 Feb 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 |
|---|---|---|---|---|---|
| CLM0003470 | 26 Jul 2025 | 361.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 78.13 |
| CLM0003471 | 22 Mar 2025 | 581.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 139.14 |