DAVID ANDERSON
Subscriber on policy B10M000111
Claims
2
Attributed to this person
Charged
843.00
Total submitted
Denied
729.00
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 | DAVID ANDERSON |
| Role on the policy | Subscriber |
| Policy | B10M000111 |
| Date of birth | 8 Sep 1971 |
| Plan | PLATINUM PPO |
| Covered from | 29 Oct 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 |
|---|---|---|---|---|---|
| CLM0000451 | 15 Dec 2025 | 114.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000452 | 20 Oct 2024 | 729.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 729.00 |