HENRY MURPHY
Subscriber on policy B02M000625
Claims
2
Attributed to this person
Charged
969.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
57.15
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 | HENRY MURPHY |
| Role on the policy | Subscriber |
| Policy | B02M000625 |
| Date of birth | 11 Sep 1981 |
| Plan | BRONZE EPO |
| Covered from | 3 Jan 2025 |
| Covered to | 1 Jul 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 57.15 |
| Total | 57.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002624 | 8 Feb 2025 | 588.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002625 | 1 Feb 2025 | 381.00 | NORTHSTAR MUTUAL | Not denied | — |