GRACE NGUYEN
Subscriber on policy B04M000230
Claims
2
Attributed to this person
Charged
349.00
Total submitted
Denied
127.00
1 denied claims
Patient responsibility
0.00
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 | GRACE NGUYEN |
| Role on the policy | Subscriber |
| Policy | B04M000230 |
| Date of birth | 18 May 2001 |
| Plan | BRONZE EPO |
| Covered from | 21 Aug 2024 |
| Covered to | 4 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001003 | 18 Jun 2025 | 127.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 127.00 |
| CLM0001004 | 5 Jun 2025 | 222.00 | MERIDIAN HEALTH PLAN | Not denied | — |