CARLA NGUYEN
Subscriber on policy B09M000157
Claims
3
Attributed to this person
Charged
1,892.00
Total submitted
Denied
399.76
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 | CARLA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B09M000157 |
| Date of birth | 13 Feb 1970 |
| Plan | BRONZE EPO |
| Covered from | 14 Feb 2025 |
| Covered to | 16 Aug 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 |
|---|---|---|---|---|---|
| CLM0000657 | 21 Jul 2025 | 214.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000658 | 12 May 2025 | 795.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000656 | 20 Mar 2025 | 883.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 399.76 |