SOFIA NGUYEN
Subscriber on policy B10M000270
Claims
3
Attributed to this person
Charged
1,066.00
Total submitted
Denied
805.00
2 denied claims
Patient responsibility
52.20
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 | SOFIA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B10M000270 |
| Date of birth | 15 Oct 1954 |
| Plan | GOLD PPO |
| Covered from | 10 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 52.20 |
| Total | 52.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001120 | 27 May 2026 | 455.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 455.00 |
| CLM0001119 | 22 Feb 2026 | 261.00 | CASCADE CARE | Not denied | — |
| CLM0001118 | 17 Sep 2025 | 350.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 350.00 |