WENDY NGUYEN
Dependent on policy B09M000242
Claims
3
Attributed to this person
Charged
815.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
412.10
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 NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000242 |
| Date of birth | 31 Jan 2006 |
| Plan | PLATINUM PPO |
| Covered from | 27 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 412.10 |
| Total | 412.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000986 | 27 May 2026 | 634.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 0.00 |
| CLM0000988 | 6 Feb 2026 | 106.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000987 | 12 Jun 2025 | 75.00 | NORTHSTAR MUTUAL | Not denied | — |