JULIA NGUYEN
Dependent on policy B02M000730
Claims
3
Attributed to this person
Charged
1,096.00
Total submitted
Denied
239.00
1 denied claims
Patient responsibility
44.00
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 | JULIA NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000730 |
| Date of birth | 1 Jun 1982 |
| Plan | BRONZE EPO |
| Covered from | 27 Feb 2025 |
| Covered to | 11 Aug 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 44.00 |
| Total | 44.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003060 | 5 Aug 2025 | 220.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003059 | 15 Jun 2025 | 637.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003061 | 27 Apr 2025 | 239.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 239.00 |