DAVID MURPHY
Subscriber on policy B02M000098
Claims
3
Attributed to this person
Charged
1,611.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
15.00
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 MURPHY |
| Role on the policy | Subscriber |
| Policy | B02M000098 |
| Date of birth | 4 Oct 1985 |
| Plan | SILVER HMO |
| Covered from | 3 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 15.00 |
| Total | 15.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000444 | 28 May 2025 | 813.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000445 | 8 Apr 2025 | 377.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000443 | 1 Nov 2024 | 421.00 | NORTHSTAR MUTUAL | Not denied | — |