LEILA NGUYEN
Subscriber on policy B10M000125
Claims
3
Attributed to this person
Charged
1,851.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
232.05
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 | LEILA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B10M000125 |
| Date of birth | 22 Dec 1975 |
| Plan | SILVER HMO |
| Covered from | 26 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 232.05 |
| Total | 232.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000531 | 25 Jul 2025 | 616.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000529 | 2 Jun 2024 | 357.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000530 | 11 May 2024 | 878.00 | MERIDIAN HEALTH PLAN | Not denied | — |