CARLA PATEL
Dependent on policy B04M000595
Claims
2
Attributed to this person
Charged
601.00
Total submitted
Denied
432.00
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 | CARLA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000595 |
| Date of birth | 28 Sep 1963 |
| Plan | PLATINUM PPO |
| Covered from | 27 Nov 2024 |
| Covered to | 8 Aug 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 |
|---|---|---|---|---|---|
| CLM0002600 | 12 Sep 2025 | 432.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 432.00 |
| CLM0002601 | 30 Dec 2024 | 169.00 | NORTHSTAR MUTUAL | Not denied | — |