CARLA WILSON
Dependent on policy B08M000799
Claims
3
Attributed to this person
Charged
734.00
Total submitted
Denied
46.89
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 | CARLA WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000799 |
| Date of birth | 14 Dec 1971 |
| Plan | SILVER HMO |
| Covered from | 22 Dec 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 |
|---|---|---|---|---|---|
| CLM0003566 | 11 Feb 2026 | 143.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 46.89 |
| CLM0003564 | 6 Aug 2025 | 422.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003565 | 19 Jan 2025 | 169.00 | NORTHSTAR MUTUAL | Not denied | — |