SOFIA NGUYEN
Dependent on policy B03M000320
Claims
2
Attributed to this person
Charged
583.00
Total submitted
Denied
513.00
1 denied claims
Patient responsibility
14.00
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 | SOFIA NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000320 |
| Date of birth | 5 Mar 2016 |
| Plan | BRONZE EPO |
| Covered from | 22 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 14.00 |
| Total | 14.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001282 | 4 Nov 2025 | 513.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 513.00 |
| CLM0001283 | 20 Feb 2025 | 70.00 | MERIDIAN HEALTH PLAN | Not denied | — |