MARCUS CHEN
Dependent on policy B04M000310
Claims
1
Attributed to this person
Charged
391.00
Total submitted
Denied
391.00
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 | MARCUS CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000310 |
| Date of birth | 10 Sep 2002 |
| Plan | BRONZE EPO |
| Covered from | 8 Oct 2024 |
| Covered to | 4 Jun 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 |
|---|---|---|---|---|---|
| CLM0001360 | 8 Dec 2024 | 391.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 391.00 |