SOFIA NGUYEN
Subscriber on policy B08M000844
Claims
1
Attributed to this person
Charged
130.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
84.50
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 | B08M000844 |
| Date of birth | 28 Oct 1973 |
| Plan | PLATINUM PPO |
| Covered from | 31 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 84.50 |
| Total | 84.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003776 | 9 Feb 2026 | 130.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |