HENRY CHEN
Dependent on policy B06M000044
Claims
1
Attributed to this person
Charged
732.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
146.40
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 | HENRY CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000044 |
| Date of birth | 31 Mar 2010 |
| Plan | BRONZE EPO |
| Covered from | 19 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 146.40 |
| Total | 146.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000248 | 20 Jun 2026 | 732.00 | NORTHSTAR MUTUAL | Not denied | — |