UMA WILSON
Subscriber on policy B09M000777
Claims
2
Attributed to this person
Charged
547.00
Total submitted
Denied
257.00
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 | UMA WILSON |
| Role on the policy | Subscriber |
| Policy | B09M000777 |
| Date of birth | 15 Mar 1994 |
| Plan | PLATINUM PPO |
| Covered from | 29 May 2025 |
| Covered to | 11 Sep 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003285 | 26 Oct 2025 | 257.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 257.00 |
| CLM0003286 | 1 Aug 2025 | 290.00 | NORTHSTAR MUTUAL | Not denied | — |