SOFIA NGUYEN
Dependent on policy B08M000821
Claims
1
Attributed to this person
Charged
177.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
26.55
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 | Dependent · relationship 01 |
| Policy | B08M000821 |
| Date of birth | 20 Apr 1970 |
| Plan | BRONZE EPO |
| Covered from | 26 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 26.55 |
| Total | 26.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003672 | 21 Apr 2025 | 177.00 | CASCADE CARE | Not denied | — |