MARCUS NGUYEN
Dependent on policy B10M000240
Claims
3
Attributed to this person
Charged
1,494.00
Total submitted
Denied
862.22
2 denied claims
Patient responsibility
30.00
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 | MARCUS NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000240 |
| Date of birth | 29 Mar 2005 |
| Plan | BRONZE EPO |
| Covered from | 18 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000988 | 23 Nov 2025 | 682.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 222.22 |
| CLM0000989 | 4 Nov 2025 | 172.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000990 | 21 Sep 2025 | 640.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 640.00 |