TOMAS NGUYEN
Subscriber on policy B09M000791
Claims
3
Attributed to this person
Charged
1,821.00
Total submitted
Denied
168.05
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 | TOMAS NGUYEN |
| Role on the policy | Subscriber |
| Policy | B09M000791 |
| Date of birth | 23 May 1976 |
| Plan | BRONZE EPO |
| Covered from | 9 Mar 2024 |
| Covered to | 10 Aug 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003332 | 13 May 2024 | 306.00 | CASCADE CARE | Not denied | — |
| CLM0003334 | 27 Mar 2024 | 717.00 | CASCADE CARE | CARC 96 · NON_COVERED | 168.05 |
| CLM0003333 | 12 Feb 2024 | 798.00 | CASCADE CARE | Not denied | — |