WENDY WILSON
Subscriber on policy B04M000088
Claims
1
Attributed to this person
Charged
351.00
Total submitted
Denied
164.30
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 | WENDY WILSON |
| Role on the policy | Subscriber |
| Policy | B04M000088 |
| Date of birth | 18 Jan 1982 |
| Plan | PLATINUM PPO |
| Covered from | 1 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 |
|---|---|---|---|---|---|
| CLM0000396 | 7 Aug 2025 | 351.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 164.30 |