KEVIN NGUYEN
Dependent on policy B10M000887
Claims
3
Attributed to this person
Charged
1,793.00
Total submitted
Denied
382.00
1 denied claims
Patient responsibility
111.40
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 | KEVIN NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000887 |
| Date of birth | 27 Jun 1995 |
| Plan | PLATINUM PPO |
| Covered from | 25 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 111.40 |
| Total | 111.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003774 | 5 Sep 2025 | 557.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003775 | 17 Jul 2025 | 382.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 382.00 |
| CLM0003776 | 27 Feb 2025 | 854.00 | MERIDIAN HEALTH PLAN | Not denied | — |