VICTOR MURPHY
Dependent on policy B09M000877
Claims
2
Attributed to this person
Charged
1,336.00
Total submitted
Denied
511.00
2 denied claims
Patient responsibility
536.25
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 | VICTOR MURPHY |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000877 |
| Date of birth | 5 Mar 2011 |
| Plan | SILVER HMO |
| Covered from | 18 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 536.25 |
| Total | 536.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003724 | 4 Apr 2026 | 511.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 511.00 |
| CLM0003725 | 25 Jul 2024 | 825.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |