RAVI WILSON
Subscriber on policy B02M000653
Claims
3
Attributed to this person
Charged
1,147.00
Total submitted
Denied
46.30
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 WILSON |
| Role on the policy | Subscriber |
| Policy | B02M000653 |
| Date of birth | 26 Aug 1977 |
| Plan | GOLD PPO |
| Covered from | 31 Jul 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002751 | 19 Feb 2025 | 848.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002749 | 9 Sep 2024 | 200.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 46.30 |
| CLM0002750 | 11 Jul 2024 | 99.00 | NORTHSTAR MUTUAL | Not denied | — |