KEVIN NGUYEN
Subscriber on policy B07M000403
Claims
2
Attributed to this person
Charged
938.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
131.30
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 | KEVIN NGUYEN |
| Role on the policy | Subscriber |
| Policy | B07M000403 |
| Date of birth | 29 Nov 2003 |
| Plan | SILVER HMO |
| Covered from | 3 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 131.30 |
| Total | 131.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001714 | 22 Aug 2026 | 736.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001713 | 11 Jul 2026 | 202.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |