UMA NGUYEN
Subscriber on policy B01M000520
Claims
1
Attributed to this person
Charged
408.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
61.20
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 | UMA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B01M000520 |
| Date of birth | 26 Apr 1978 |
| Plan | SILVER HMO |
| Covered from | 16 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 61.20 |
| Total | 61.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002344 | 4 Oct 2025 | 408.00 | MERIDIAN HEALTH PLAN | Not denied | — |