VICTOR MURPHY
Dependent on policy B05M000618
Claims
2
Attributed to this person
Charged
533.00
Total submitted
Denied
110.23
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 | VICTOR MURPHY |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000618 |
| Date of birth | 21 Mar 1984 |
| Plan | BRONZE EPO |
| Covered from | 13 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 |
|---|---|---|---|---|---|
| CLM0002655 | 25 Dec 2024 | 230.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 110.23 |
| CLM0002656 | 28 Nov 2024 | 303.00 | NORTHSTAR MUTUAL | Not denied | — |