DAVID NGUYEN
Dependent on policy B07M000105
Claims
3
Attributed to this person
Charged
1,165.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.40
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 | DAVID NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000105 |
| Date of birth | 4 Dec 2007 |
| Plan | SILVER HMO |
| Covered from | 18 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 40.40 |
| Total | 40.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000435 | 5 Jun 2026 | 202.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000434 | 4 Oct 2024 | 701.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000433 | 5 Jul 2024 | 262.00 | MERIDIAN HEALTH PLAN | Not denied | — |