KEVIN NGUYEN
Dependent on policy B08M000844
Claims
3
Attributed to this person
Charged
1,814.00
Total submitted
Denied
1,250.00
3 denied claims
Patient responsibility
366.60
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 | KEVIN NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000844 |
| Date of birth | 15 Apr 1965 |
| Plan | PLATINUM PPO |
| Covered from | 31 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 366.60 |
| Total | 366.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003777 | 15 Mar 2025 | 360.00 | CASCADE CARE | CARC 109 · COB | 360.00 |
| CLM0003778 | 16 Dec 2024 | 890.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 890.00 |
| CLM0003779 | 15 Sep 2024 | 564.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |