BRIAN MURPHY
Dependent on policy B02M000625
Claims
1
Attributed to this person
Charged
763.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
114.45
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 | BRIAN MURPHY |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000625 |
| Date of birth | 23 Aug 1983 |
| 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 | 114.45 |
| Total | 114.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002626 | 1 Apr 2025 | 763.00 | NORTHSTAR MUTUAL | Not denied | — |