OMAR NGUYEN
Dependent on policy B02M000304
Claims
1
Attributed to this person
Charged
895.00
Total submitted
Denied
403.55
1 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 | OMAR NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000304 |
| Date of birth | 7 Jun 1971 |
| Plan | PLATINUM PPO |
| Covered from | 30 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001315 | 3 Jan 2026 | 895.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 403.55 |