VICTOR CHEN
Subscriber on policy B01M000321
Claims
2
Attributed to this person
Charged
674.00
Total submitted
Denied
454.91
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 | VICTOR CHEN |
| Role on the policy | Subscriber |
| Policy | B01M000321 |
| Date of birth | 6 Jun 1985 |
| Plan | SILVER HMO |
| Covered from | 10 Mar 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 |
|---|---|---|---|---|---|
| CLM0001422 | 1 Sep 2025 | 401.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 181.91 |
| CLM0001423 | 10 Jul 2024 | 273.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 273.00 |