ELENA NGUYEN
Subscriber on policy B02M000730
Claims
1
Attributed to this person
Charged
756.00
Total submitted
Denied
756.00
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 | ELENA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B02M000730 |
| Date of birth | 24 Sep 1961 |
| Plan | BRONZE EPO |
| Covered from | 27 Feb 2025 |
| Covered to | 11 Aug 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003057 | 18 Apr 2025 | 756.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 756.00 |