TOMAS NGUYEN
Dependent on policy B04M000236
Claims
1
Attributed to this person
Charged
177.00
Total submitted
Denied
0.00
0 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 | TOMAS NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000236 |
| Date of birth | 16 Feb 1982 |
| Plan | BRONZE EPO |
| Covered from | 16 Oct 2024 |
| Covered to | 2 Jul 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 |
|---|---|---|---|---|---|
| CLM0001027 | 17 Oct 2024 | 177.00 | NORTHSTAR MUTUAL | Not denied | — |