VICTOR NGUYEN
Dependent on policy B01M000714
Claims
3
Attributed to this person
Charged
1,047.00
Total submitted
Denied
468.00
2 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 | VICTOR NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000714 |
| Date of birth | 9 Sep 2011 |
| Plan | SILVER HMO |
| Covered from | 8 Apr 2024 |
| Covered to | 11 Jul 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 |
|---|---|---|---|---|---|
| CLM0003186 | 7 Sep 2024 | 316.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 316.00 |
| CLM0003187 | 23 Aug 2024 | 152.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 152.00 |
| CLM0003185 | 19 Jun 2024 | 579.00 | CASCADE CARE | Not denied | — |