CARLA NGUYEN
Subscriber on policy B06M000444
Claims
2
Attributed to this person
Charged
1,170.00
Total submitted
Denied
864.00
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 | CARLA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B06M000444 |
| Date of birth | 24 May 1986 |
| Plan | BRONZE EPO |
| Covered from | 28 Feb 2024 |
| Covered to | 1 Jul 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002026 | 26 Apr 2024 | 306.00 | CASCADE CARE | Not denied | — |
| CLM0002027 | 5 Apr 2024 | 864.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 864.00 |