HENRY NGUYEN
Subscriber on policy B09M000547
Claims
2
Attributed to this person
Charged
1,186.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
467.35
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 | HENRY NGUYEN |
| Role on the policy | Subscriber |
| Policy | B09M000547 |
| Date of birth | 20 Nov 1997 |
| Plan | PLATINUM PPO |
| Covered from | 29 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 467.35 |
| Total | 467.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002298 | 13 Oct 2025 | 467.00 | CASCADE CARE | Not denied | — |
| CLM0002299 | 23 Jan 2025 | 719.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |