PRIYA WILSON
Dependent on policy B10M000815
Claims
3
Attributed to this person
Charged
2,187.00
Total submitted
Denied
258.03
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 | PRIYA WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000815 |
| Date of birth | 9 Oct 1968 |
| Plan | GOLD PPO |
| Covered from | 1 May 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 |
|---|---|---|---|---|---|
| CLM0003444 | 12 Jul 2026 | 693.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003445 | 27 May 2025 | 789.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 258.03 |
| CLM0003443 | 17 Jan 2025 | 705.00 | NORTHSTAR MUTUAL | Not denied | — |