KEVIN WILSON
Dependent on policy B01M000307
Claims
2
Attributed to this person
Charged
762.00
Total submitted
Denied
478.00
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 | KEVIN WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000307 |
| Date of birth | 9 Sep 1975 |
| 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 |
|---|---|---|---|---|---|
| CLM0001355 | 4 Sep 2025 | 478.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 478.00 |
| CLM0001356 | 2 Apr 2025 | 284.00 | NORTHSTAR MUTUAL | Not denied | — |