YUSUF WILSON
Subscriber on policy B03M000454
Claims
3
Attributed to this person
Charged
1,440.00
Total submitted
Denied
1,440.00
3 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 | YUSUF WILSON |
| Role on the policy | Subscriber |
| Policy | B03M000454 |
| Date of birth | 16 Jun 2001 |
| Plan | BRONZE EPO |
| Covered from | 29 Oct 2024 |
| Covered to | 9 May 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001875 | 3 Jul 2025 | 542.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 542.00 |
| CLM0001876 | 10 Jan 2025 | 553.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 553.00 |
| CLM0001874 | 4 Oct 2024 | 345.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 345.00 |