RAVI WILSON
Dependent on policy B09M000835
Claims
3
Attributed to this person
Charged
1,758.00
Total submitted
Denied
161.02
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 | RAVI WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000835 |
| Date of birth | 5 Mar 2010 |
| Plan | SILVER HMO |
| Covered from | 10 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 |
|---|---|---|---|---|---|
| CLM0003558 | 19 Aug 2026 | 639.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003556 | 2 Feb 2026 | 722.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003557 | 23 Oct 2025 | 397.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 161.02 |