BRIAN WILSON
Dependent on policy B05M000322
Claims
2
Attributed to this person
Charged
1,407.00
Total submitted
Denied
171.67
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 | BRIAN WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000322 |
| Date of birth | 1 Dec 1993 |
| Plan | PLATINUM PPO |
| Covered from | 29 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 | 24 Jan 2026 | 673.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001353 | 4 Jul 2024 | 734.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 171.67 |