CARLA MURPHY
Dependent on policy B05M000618
Claims
2
Attributed to this person
Charged
543.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
91.00
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 | CARLA MURPHY |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000618 |
| Date of birth | 30 Jun 2013 |
| Plan | BRONZE EPO |
| Covered from | 13 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 71.00 |
| CARC 3 · Copay | 1 | 20.00 |
| Total | 91.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002659 | 26 Mar 2025 | 188.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002658 | 27 Jan 2024 | 355.00 | NORTHSTAR MUTUAL | Not denied | — |