LEILA NGUYEN
Subscriber on policy B08M000127
Claims
2
Attributed to this person
Charged
857.00
Total submitted
Denied
857.00
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 | LEILA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B08M000127 |
| Date of birth | 24 Nov 2004 |
| Plan | GOLD PPO |
| Covered from | 29 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000570 | 29 Nov 2024 | 79.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 79.00 |
| CLM0000569 | 29 Oct 2024 | 778.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 778.00 |