DAVID NGUYEN
Dependent on policy B07M000455
Claims
1
Attributed to this person
Charged
266.00
Total submitted
Denied
266.00
1 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 | DAVID NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000455 |
| Date of birth | 24 Jul 1966 |
| Plan | PLATINUM PPO |
| Covered from | 12 Jan 2025 |
| Covered to | 26 Oct 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 |
|---|---|---|---|---|---|
| CLM0001916 | 20 Apr 2025 | 266.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 266.00 |