ELENA NGUYEN
Subscriber on policy B04M000324
Claims
1
Attributed to this person
Charged
733.00
Total submitted
Denied
733.00
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 โ 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 | ELENA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B04M000324 |
| Date of birth | 1 Oct 1959 |
| Plan | BRONZE EPO |
| Covered from | 2 Jun 2025 |
| Covered to | 24 Jan 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001409 | 27 Jan 2026 | 733.00 | CASCADE CARE | CARC 26 ยท ELIGIBILITY | 733.00 |