BRIAN CHEN
Dependent on policy B02M000568
Claims
2
Attributed to this person
Charged
650.00
Total submitted
Denied
353.00
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 | BRIAN CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000568 |
| Date of birth | 15 Mar 1957 |
| Plan | GOLD PPO |
| Covered from | 3 Jan 2025 |
| Covered to | 18 Jul 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002391 | 4 Aug 2025 | 353.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 353.00 |
| CLM0002390 | 3 Feb 2025 | 297.00 | NORTHSTAR MUTUAL | Not denied | — |