DAVID MURPHY
Dependent on policy B09M000164
Claims
2
Attributed to this person
Charged
967.00
Total submitted
Denied
967.00
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 | DAVID MURPHY |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000164 |
| Date of birth | 15 Apr 1946 |
| Plan | SILVER HMO |
| Covered from | 17 Aug 2024 |
| Covered to | 2 Nov 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000689 | 25 Dec 2024 | 161.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 161.00 |
| CLM0000688 | 21 Dec 2024 | 806.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 806.00 |