BRIAN NGUYEN
Dependent on policy B10M000488
Claims
3
Attributed to this person
Charged
1,302.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
89.10
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 | BRIAN NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000488 |
| Date of birth | 25 Sep 1995 |
| Plan | PLATINUM PPO |
| Covered from | 29 May 2024 |
| Covered to | 15 Mar 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 89.10 |
| Total | 89.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002023 | 18 Mar 2025 | 594.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002025 | 7 Dec 2024 | 431.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002024 | 20 Jun 2024 | 277.00 | NORTHSTAR MUTUAL | Not denied | — |