PRIYA CHEN
Subscriber on policy B06M000090
Claims
1
Attributed to this person
Charged
388.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
58.20
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 | PRIYA CHEN |
| Role on the policy | Subscriber |
| Policy | B06M000090 |
| Date of birth | 20 Jan 1970 |
| Plan | BRONZE EPO |
| Covered from | 1 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 58.20 |
| Total | 58.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000472 | 27 Jan 2026 | 388.00 | NORTHSTAR MUTUAL | Not denied | — |