MARCUS WILSON
Dependent on policy B01M000428
Claims
3
Attributed to this person
Charged
1,453.00
Total submitted
Denied
968.68
2 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 | MARCUS WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000428 |
| Date of birth | 23 Sep 1993 |
| Plan | PLATINUM PPO |
| Covered from | 4 Dec 2024 |
| Covered to | 9 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 |
|---|---|---|---|---|---|
| CLM0001884 | 21 Aug 2025 | 812.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 812.00 |
| CLM0001882 | 26 Jun 2025 | 369.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 156.68 |
| CLM0001883 | 1 Apr 2025 | 272.00 | NORTHSTAR MUTUAL | Not denied | — |