HENRY CHEN
Subscriber on policy B02M000450
Claims
1
Attributed to this person
Charged
872.00
Total submitted
Denied
418.68
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 | HENRY CHEN |
| Role on the policy | Subscriber |
| Policy | B02M000450 |
| Date of birth | 20 Sep 2002 |
| Plan | GOLD PPO |
| Covered from | 23 Feb 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 |
|---|---|---|---|---|---|
| CLM0001917 | 14 Jun 2026 | 872.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 418.68 |