RAVI PATEL
Subscriber on policy B05M000542
Claims
3
Attributed to this person
Charged
2,317.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
128.55
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 | RAVI PATEL |
| Role on the policy | Subscriber |
| Policy | B05M000542 |
| Date of birth | 26 Sep 1978 |
| Plan | PLATINUM PPO |
| Covered from | 27 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 128.55 |
| Total | 128.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002315 | 22 Jul 2026 | 780.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002314 | 22 Nov 2025 | 857.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002313 | 26 Jun 2025 | 680.00 | NORTHSTAR MUTUAL | Not denied | — |