KEVIN WILSON
Dependent on policy B10M000786
Claims
3
Attributed to this person
Charged
1,747.00
Total submitted
Denied
0.00
0 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 | KEVIN WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000786 |
| Date of birth | 21 Jul 1984 |
| Plan | GOLD PPO |
| Covered from | 2 Jun 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003326 | 24 Nov 2025 | 221.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003325 | 12 Sep 2025 | 871.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003324 | 14 Aug 2025 | 655.00 | NORTHSTAR MUTUAL | Not denied | — |