SOFIA NGUYEN
Dependent on policy B05M000611
Claims
1
Attributed to this person
Charged
397.00
Total submitted
Denied
397.00
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 | SOFIA NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000611 |
| Date of birth | 7 Aug 1956 |
| Plan | SILVER HMO |
| Covered from | 4 Dec 2024 |
| Covered to | 7 May 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 |
|---|---|---|---|---|---|
| CLM0002620 | 8 Jun 2025 | 397.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 397.00 |