UMA ANDERSON
Subscriber on policy B02M000416
Claims
1
Attributed to this person
Charged
547.00
Total submitted
Denied
166.50
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 | UMA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B02M000416 |
| Date of birth | 16 Jan 2000 |
| Plan | GOLD PPO |
| Covered from | 16 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001778 | 1 Aug 2025 | 547.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 166.50 |