WENDY MURPHY
Dependent on policy B04M000174
Claims
2
Attributed to this person
Charged
392.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
163.80
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 MURPHY |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000174 |
| Date of birth | 31 Mar 1993 |
| Plan | BRONZE EPO |
| Covered from | 9 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 163.80 |
| Total | 163.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000789 | 20 Jun 2026 | 252.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000790 | 23 Jan 2025 | 140.00 | NORTHSTAR MUTUAL | Not denied | — |