KEVIN PATEL
Subscriber on policy B09M000161
Claims
2
Attributed to this person
Charged
551.00
Total submitted
Denied
324.00
1 denied claims
Patient responsibility
45.40
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 | KEVIN PATEL |
| Role on the policy | Subscriber |
| Policy | B09M000161 |
| Date of birth | 16 Mar 1980 |
| Plan | SILVER HMO |
| Covered from | 12 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 45.40 |
| Total | 45.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000671 | 26 Mar 2026 | 324.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 324.00 |
| CLM0000670 | 22 Sep 2025 | 227.00 | NORTHSTAR MUTUAL | Not denied | — |