SOFIA NGUYEN
Subscriber on policy B07M000106
Claims
2
Attributed to this person
Charged
981.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
20.00
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 | SOFIA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B07M000106 |
| Date of birth | 29 Mar 1984 |
| Plan | BRONZE EPO |
| Covered from | 1 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000437 | 16 Feb 2025 | 96.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000436 | 27 Jun 2024 | 885.00 | MERIDIAN HEALTH PLAN | Not denied | — |