IVAN NGUYEN
Subscriber on policy B03M000397
Claims
2
Attributed to this person
Charged
1,242.00
Total submitted
Denied
791.00
1 denied claims
Patient responsibility
67.65
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 | IVAN NGUYEN |
| Role on the policy | Subscriber |
| Policy | B03M000397 |
| Date of birth | 27 Aug 1952 |
| Plan | PLATINUM PPO |
| Covered from | 25 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 67.65 |
| Total | 67.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001606 | 3 Nov 2025 | 451.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001607 | 19 Mar 2025 | 791.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 791.00 |