BRIAN ANDERSON
Subscriber on policy B04M000414
Claims
2
Attributed to this person
Charged
762.00
Total submitted
Denied
124.55
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 | BRIAN ANDERSON |
| Role on the policy | Subscriber |
| Policy | B04M000414 |
| Date of birth | 18 Aug 1964 |
| Plan | PLATINUM PPO |
| Covered from | 11 May 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001773 | 23 May 2026 | 498.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001772 | 14 Mar 2026 | 264.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 124.55 |