VICTOR NGUYEN
Dependent on policy B04M000301
Claims
2
Attributed to this person
Charged
1,055.00
Total submitted
Denied
1,055.00
2 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 | VICTOR NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000301 |
| Date of birth | 7 Jan 2008 |
| Plan | SILVER HMO |
| Covered from | 25 Dec 2024 |
| Covered to | 28 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 |
|---|---|---|---|---|---|
| CLM0001315 | 13 Feb 2025 | 516.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 516.00 |
| CLM0001314 | 7 Feb 2025 | 539.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 539.00 |