JULIA CHEN
Subscriber on policy B04M000500
Claims
2
Attributed to this person
Charged
959.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
22.95
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 CHEN |
| Role on the policy | Subscriber |
| Policy | B04M000500 |
| Date of birth | 20 Oct 1995 |
| Plan | PLATINUM PPO |
| Covered from | 6 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 22.95 |
| Total | 22.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002146 | 27 Jan 2026 | 806.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002148 | 28 Nov 2024 | 153.00 | NORTHSTAR MUTUAL | Not denied | — |