VICTOR MURPHY
Dependent on policy B02M000267
Claims
1
Attributed to this person
Charged
698.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.00
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 MURPHY |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000267 |
| Date of birth | 27 Mar 2018 |
| Plan | BRONZE EPO |
| Covered from | 27 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001170 | 14 Aug 2025 | 698.00 | NORTHSTAR MUTUAL | Not denied | — |