UMA NGUYEN
Dependent on policy B10M000121
Claims
1
Attributed to this person
Charged
324.00
Total submitted
Denied
66.06
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 | UMA NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000121 |
| Date of birth | 5 Jun 1981 |
| Plan | PLATINUM PPO |
| Covered from | 15 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000511 | 15 Aug 2024 | 324.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 66.06 |