GRACE NGUYEN
Dependent on policy B04M000773
Claims
2
Attributed to this person
Charged
895.00
Total submitted
Denied
25.21
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 | Dependent · relationship 19 |
| Policy | B04M000773 |
| Date of birth | 13 Apr 1997 |
| Plan | BRONZE EPO |
| Covered from | 17 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003365 | 31 May 2026 | 376.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 25.21 |
| CLM0003364 | 27 Jan 2026 | 519.00 | MERIDIAN HEALTH PLAN | Not denied | — |