KEVIN NGUYEN
Subscriber on policy B05M000230
Claims
3
Attributed to this person
Charged
1,091.00
Total submitted
Denied
300.00
2 denied claims
Patient responsibility
158.20
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 | KEVIN NGUYEN |
| Role on the policy | Subscriber |
| Policy | B05M000230 |
| Date of birth | 5 Mar 1980 |
| Plan | SILVER HMO |
| Covered from | 19 Nov 2024 |
| Covered to | 8 May 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 158.20 |
| Total | 158.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000951 | 1 May 2025 | 102.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 102.00 |
| CLM0000950 | 28 Mar 2025 | 791.00 | CASCADE CARE | Not denied | — |
| CLM0000952 | 8 Feb 2025 | 198.00 | CASCADE CARE | CARC 11 · CODING | 198.00 |