ELENA NGUYEN
Subscriber on policy B05M000353
Claims
3
Attributed to this person
Charged
1,347.00
Total submitted
Denied
266.00
1 denied claims
Patient responsibility
63.15
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 | ELENA NGUYEN |
| Role on the policy | Subscriber |
| Policy | B05M000353 |
| Date of birth | 20 Jun 1990 |
| Plan | SILVER HMO |
| Covered from | 24 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 63.15 |
| Total | 63.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001508 | 10 Apr 2026 | 660.00 | CASCADE CARE | Not denied | — |
| CLM0001506 | 28 Jan 2026 | 421.00 | CASCADE CARE | Not denied | — |
| CLM0001507 | 8 Jan 2026 | 266.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 266.00 |