MARCUS CHEN
Dependent on policy B08M000023
Claims
2
Attributed to this person
Charged
553.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
60.45
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 | MARCUS CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000023 |
| Date of birth | 29 Sep 1982 |
| Plan | PLATINUM PPO |
| Covered from | 18 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 60.45 |
| Total | 60.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000103 | 6 Dec 2025 | 93.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000102 | 20 Sep 2025 | 460.00 | NORTHSTAR MUTUAL | Not denied | — |