WENDY PATEL
Dependent on policy B02M000803
Claims
1
Attributed to this person
Charged
115.00
Total submitted
Denied
24.69
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 | WENDY PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000803 |
| Date of birth | 14 Aug 1994 |
| Plan | PLATINUM PPO |
| Covered from | 21 Jan 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 |
|---|---|---|---|---|---|
| CLM0003353 | 18 Mar 2025 | 115.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 24.69 |