CARLA NGUYEN
Dependent on policy B07M000447
Claims
2
Attributed to this person
Charged
1,016.00
Total submitted
Denied
1,016.00
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 | CARLA NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000447 |
| Date of birth | 24 May 1996 |
| Plan | BRONZE EPO |
| Covered from | 20 Aug 2024 |
| Covered to | 27 Feb 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001886 | 26 Dec 2024 | 735.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 735.00 |
| CLM0001887 | 2 Aug 2024 | 281.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 281.00 |