RAVI CHEN
Dependent on policy B02M000565
Claims
2
Attributed to this person
Charged
811.00
Total submitted
Denied
110.00
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 | RAVI CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000565 |
| Date of birth | 15 Sep 1949 |
| Plan | GOLD PPO |
| Covered from | 22 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0002377 | 21 Mar 2026 | 701.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002378 | 20 Jan 2025 | 110.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 110.00 |