ZARA NGUYEN
Dependent on policy B07M000455
Claims
2
Attributed to this person
Charged
641.00
Total submitted
Denied
641.00
2 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 | ZARA NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000455 |
| Date of birth | 24 Dec 1993 |
| 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 |
|---|---|---|---|---|---|
| CLM0001919 | 10 Nov 2025 | 76.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 76.00 |
| CLM0001920 | 28 Jan 2025 | 565.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 565.00 |