LEILA ANDERSON
Subscriber on policy B10M000775
Claims
1
Attributed to this person
Charged
108.00
Total submitted
Denied
108.00
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 | LEILA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B10M000775 |
| Date of birth | 30 Apr 1976 |
| Plan | SILVER HMO |
| Covered from | 25 Jan 2025 |
| Covered to | 18 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 |
|---|---|---|---|---|---|
| CLM0003240 | 21 Sep 2025 | 108.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 108.00 |