RAVI ANDERSON
Dependent on policy B02M000339
Claims
3
Attributed to this person
Charged
797.00
Total submitted
Denied
243.00
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 | RAVI ANDERSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000339 |
| Date of birth | 23 Nov 1998 |
| Plan | BRONZE EPO |
| Covered from | 20 Feb 2024 |
| Covered to | 27 Nov 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 |
|---|---|---|---|---|---|
| CLM0001443 | 18 Jul 2024 | 121.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001442 | 11 Apr 2024 | 433.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001441 | 12 Feb 2024 | 243.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 243.00 |