ZARA WILSON
Dependent on policy B01M000327
Claims
1
Attributed to this person
Charged
194.00
Total submitted
Denied
92.49
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 | ZARA WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000327 |
| Date of birth | 23 Jun 1989 |
| Plan | BRONZE EPO |
| Covered from | 21 Jun 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 |
|---|---|---|---|---|---|
| CLM0001455 | 19 May 2026 | 194.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 92.49 |