UMA MURPHY
Dependent on policy B03M000184
Claims
3
Attributed to this person
Charged
1,326.00
Total submitted
Denied
277.00
3 denied claims
Patient responsibility
681.85
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 MURPHY |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000184 |
| Date of birth | 16 Nov 1944 |
| Plan | GOLD PPO |
| Covered from | 13 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 381.55 |
| CARC 50 · Other | 1 | 300.30 |
| Total | 681.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000756 | 15 Apr 2026 | 277.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 277.00 |
| CLM0000755 | 7 Jul 2025 | 462.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000754 | 20 May 2025 | 587.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 0.00 |