FIONA NGUYEN
Subscriber on policy B03M000400
Claims
3
Attributed to this person
Charged
2,365.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
570.05
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 | FIONA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B03M000400 |
| Date of birth | 9 May 1985 |
| Plan | GOLD PPO |
| Covered from | 22 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 570.05 |
| Total | 570.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001622 | 4 Jun 2026 | 686.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001623 | 16 Aug 2025 | 877.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0001621 | 5 Dec 2024 | 802.00 | MERIDIAN HEALTH PLAN | Not denied | — |