IVAN WILSON
Dependent on policy B08M000799
Claims
2
Attributed to this person
Charged
931.00
Total submitted
Denied
534.00
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 | IVAN WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000799 |
| Date of birth | 8 Jul 2013 |
| 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 |
|---|---|---|---|---|---|
| CLM0003569 | 26 Dec 2025 | 397.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003568 | 14 Dec 2025 | 534.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 534.00 |