VICTOR ANDERSON
Subscriber on policy B02M000189
Claims
1
Attributed to this person
Charged
396.00
Total submitted
Denied
396.00
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 | VICTOR ANDERSON |
| Role on the policy | Subscriber |
| Policy | B02M000189 |
| Date of birth | 6 Apr 1991 |
| Plan | SILVER HMO |
| Covered from | 2 Dec 2024 |
| Covered to | 13 Apr 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 |
|---|---|---|---|---|---|
| CLM0000832 | 20 Mar 2025 | 396.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 396.00 |