JULIA CHEN
Dependent on policy B02M000020
Claims
2
Attributed to this person
Charged
1,450.00
Total submitted
Denied
828.00
1 denied claims
Patient responsibility
93.30
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 | JULIA CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000020 |
| Date of birth | 8 Sep 1988 |
| Plan | GOLD PPO |
| Covered from | 3 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 93.30 |
| Total | 93.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000121 | 13 Jun 2026 | 622.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000122 | 6 Aug 2024 | 828.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 828.00 |