JULIA NGUYEN
Subscriber on policy B03M000480
Claims
2
Attributed to this person
Charged
1,199.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
95.85
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 | JULIA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B03M000480 |
| Date of birth | 22 Jan 1990 |
| Plan | GOLD PPO |
| Covered from | 30 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 95.85 |
| Total | 95.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002003 | 29 Dec 2025 | 560.00 | CASCADE CARE | Not denied | — |
| CLM0002004 | 7 Apr 2025 | 639.00 | CASCADE CARE | Not denied | — |