HENRY MURPHY
Subscriber on policy B03M000671
Claims
2
Attributed to this person
Charged
924.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
75.40
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 | HENRY MURPHY |
| Role on the policy | Subscriber |
| Policy | B03M000671 |
| Date of birth | 8 Sep 1968 |
| Plan | PLATINUM PPO |
| Covered from | 23 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 75.40 |
| Total | 75.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002780 | 10 Jul 2026 | 808.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002779 | 26 Apr 2025 | 116.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |