VICTOR ANDERSON
Dependent on policy B05M000045
Claims
3
Attributed to this person
Charged
1,929.00
Total submitted
Denied
1,314.00
2 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 | VICTOR ANDERSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000045 |
| Date of birth | 9 Mar 1974 |
| Plan | SILVER HMO |
| Covered from | 15 Jan 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 |
|---|---|---|---|---|---|
| CLM0000203 | 25 Aug 2026 | 615.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000202 | 28 Feb 2025 | 707.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 707.00 |
| CLM0000201 | 29 Jan 2025 | 607.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 607.00 |