DAVID WILSON
Dependent on policy B01M000307
Claims
2
Attributed to this person
Charged
552.00
Total submitted
Denied
359.00
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 | DAVID WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000307 |
| Date of birth | 22 Jul 1952 |
| 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 |
|---|---|---|---|---|---|
| CLM0001353 | 19 Aug 2026 | 193.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001354 | 8 Oct 2025 | 359.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 359.00 |