KEVIN WILSON
Subscriber on policy B01M000307
Claims
2
Attributed to this person
Charged
901.00
Total submitted
Denied
135.91
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 | KEVIN WILSON |
| Role on the policy | Subscriber |
| Policy | B01M000307 |
| Date of birth | 7 Aug 1951 |
| Plan | GOLD PPO |
| Covered from | 24 Feb 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 |
|---|---|---|---|---|---|
| CLM0001352 | 12 Mar 2025 | 446.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001351 | 8 Apr 2024 | 455.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 135.91 |