PRIYA ANDERSON
Subscriber on policy B02M000094
Claims
2
Attributed to this person
Charged
1,159.00
Total submitted
Denied
1,159.00
2 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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B02M000094 |
| Date of birth | 16 Jul 1982 |
| Plan | SILVER HMO |
| Covered from | 14 Jan 2024 |
| Covered to | 18 Jul 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000428 | 12 Jan 2024 | 817.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 817.00 |
| CLM0000429 | 30 Dec 2023 | 342.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 342.00 |