HENRY NGUYEN
Dependent on policy B05M000191
Claims
2
Attributed to this person
Charged
948.00
Total submitted
Denied
684.00
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 | HENRY NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000191 |
| Date of birth | 23 Feb 2013 |
| Plan | PLATINUM PPO |
| Covered from | 21 Mar 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000805 | 12 Feb 2026 | 264.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000804 | 10 Jan 2026 | 684.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 684.00 |