ELENA NGUYEN
Subscriber on policy B10M000000
Claims
2
Attributed to this person
Charged
821.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
39.90
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 | ELENA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B10M000000 |
| Date of birth | 29 Sep 1964 |
| Plan | PLATINUM PPO |
| Covered from | 9 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 39.90 |
| Total | 39.90 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000001 | 26 Sep 2025 | 266.00 | CASCADE CARE | Not denied | — |
| CLM0000002 | 31 Jan 2025 | 555.00 | CASCADE CARE | Not denied | — |