YUSUF NGUYEN
Subscriber on policy B01M000672
Claims
3
Attributed to this person
Charged
525.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
43.05
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 | YUSUF NGUYEN |
| Role on the policy | Subscriber |
| Policy | B01M000672 |
| Date of birth | 25 Feb 1973 |
| Plan | SILVER HMO |
| Covered from | 15 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 28.05 |
| CARC 3 · Copay | 1 | 15.00 |
| Total | 43.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003011 | 7 Mar 2026 | 113.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003010 | 5 Jun 2025 | 225.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003009 | 13 Feb 2025 | 187.00 | MERIDIAN HEALTH PLAN | Not denied | — |