ZARA ANDERSON
Subscriber on policy B05M000493
Claims
1
Attributed to this person
Charged
620.00
Total submitted
Denied
620.00
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 | ZARA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B05M000493 |
| Date of birth | 6 Oct 1982 |
| Plan | GOLD PPO |
| Covered from | 14 Oct 2024 |
| Covered to | 31 Jul 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002107 | 15 Sep 2024 | 620.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 620.00 |