KEVIN NGUYEN
Dependent on policy B03M000121
Claims
2
Attributed to this person
Charged
880.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
49.40
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 | KEVIN NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000121 |
| Date of birth | 18 Aug 1954 |
| Plan | GOLD PPO |
| Covered from | 16 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 49.40 |
| Total | 49.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000474 | 9 Apr 2026 | 247.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000473 | 25 Jul 2025 | 633.00 | MERIDIAN HEALTH PLAN | Not denied | — |