DAVID NGUYEN
Dependent on policy B09M000553
Claims
2
Attributed to this person
Charged
985.00
Total submitted
Denied
395.00
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 | DAVID NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000553 |
| Date of birth | 6 Apr 2006 |
| Plan | GOLD PPO |
| Covered from | 3 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002335 | 15 Apr 2026 | 590.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002334 | 20 Nov 2024 | 395.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 395.00 |