BRIAN NGUYEN
Dependent on policy B03M000007
Claims
2
Attributed to this person
Charged
643.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
63.75
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 | BRIAN NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000007 |
| Date of birth | 25 Apr 1953 |
| Plan | BRONZE EPO |
| Covered from | 24 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 48.75 |
| CARC 3 · Copay | 1 | 15.00 |
| Total | 63.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000037 | 5 May 2026 | 75.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000036 | 18 Nov 2025 | 568.00 | CASCADE CARE | Not denied | — |