BRIAN ANDERSON
Dependent on policy B05M000493
Claims
2
Attributed to this person
Charged
970.00
Total submitted
Denied
574.00
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 | BRIAN ANDERSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000493 |
| Date of birth | 3 Jun 2008 |
| 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 |
|---|---|---|---|---|---|
| CLM0002112 | 15 Sep 2025 | 396.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002111 | 18 Aug 2025 | 574.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 574.00 |