SOFIA NGUYEN
Dependent on policy B09M000787
Claims
2
Attributed to this person
Charged
296.00
Total submitted
Denied
186.00
1 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 | SOFIA NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000787 |
| Date of birth | 2 Sep 1945 |
| Plan | BRONZE EPO |
| Covered from | 5 Jul 2024 |
| Covered to | 21 Jan 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003324 | 7 Dec 2024 | 110.00 | CASCADE CARE | Not denied | — |
| CLM0003325 | 16 Aug 2024 | 186.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 186.00 |