FIONA NGUYEN
Subscriber on policy B07M000721
Claims
2
Attributed to this person
Charged
905.00
Total submitted
Denied
73.00
1 denied claims
Patient responsibility
166.40
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 | FIONA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B07M000721 |
| Date of birth | 18 Mar 1951 |
| Plan | GOLD PPO |
| Covered from | 5 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 166.40 |
| Total | 166.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002970 | 4 Jul 2025 | 832.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002969 | 28 Oct 2024 | 73.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 73.00 |