RAVI CHEN
Dependent on policy B05M000060
Claims
3
Attributed to this person
Charged
1,167.00
Total submitted
Denied
340.91
2 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 19 |
| Policy | B05M000060 |
| Date of birth | 23 Feb 2013 |
| Plan | GOLD PPO |
| Covered from | 18 Jun 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0000289 | 3 Apr 2025 | 214.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000290 | 2 Jan 2025 | 812.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 199.91 |
| CLM0000288 | 29 Dec 2024 | 141.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 141.00 |