ZARA NGUYEN
Subscriber on policy B06M000195
Claims
1
Attributed to this person
Charged
323.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.00
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 | ZARA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B06M000195 |
| Date of birth | 7 Apr 1950 |
| Plan | PLATINUM PPO |
| Covered from | 27 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000948 | 9 Jul 2026 | 323.00 | NORTHSTAR MUTUAL | Not denied | — |