WENDY CHEN
Dependent on policy B08M000195
Claims
3
Attributed to this person
Charged
1,710.00
Total submitted
Denied
890.00
2 denied claims
Patient responsibility
123.00
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 | WENDY CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000195 |
| Date of birth | 22 Sep 2009 |
| Plan | BRONZE EPO |
| Covered from | 6 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 123.00 |
| Total | 123.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000871 | 3 Jul 2026 | 421.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 421.00 |
| CLM0000870 | 21 Feb 2025 | 820.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000872 | 2 Oct 2024 | 469.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 469.00 |