LEILA ANDERSON
Dependent on policy B01M000416
Claims
3
Attributed to this person
Charged
905.00
Total submitted
Denied
181.00
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 | LEILA ANDERSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000416 |
| Date of birth | 16 Feb 1983 |
| Plan | PLATINUM PPO |
| Covered from | 20 Feb 2024 |
| Covered to | 12 Jun 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001847 | 4 Aug 2024 | 298.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001845 | 12 Jul 2024 | 426.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001846 | 9 Jun 2024 | 181.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 181.00 |