JULIA PATEL
Dependent on policy B09M000152
Claims
3
Attributed to this person
Charged
1,492.00
Total submitted
Denied
160.00
1 denied claims
Patient responsibility
123.40
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 | JULIA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000152 |
| Date of birth | 23 Feb 1962 |
| Plan | SILVER HMO |
| Covered from | 4 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 123.40 |
| Total | 123.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000647 | 7 May 2025 | 715.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000646 | 26 Apr 2025 | 160.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 160.00 |
| CLM0000645 | 15 Jul 2024 | 617.00 | NORTHSTAR MUTUAL | Not denied | — |