DAVID NGUYEN
Dependent on policy B05M000476
Claims
3
Attributed to this person
Charged
1,832.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
94.50
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 | DAVID NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000476 |
| Date of birth | 14 Nov 2006 |
| Plan | GOLD PPO |
| Covered from | 29 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 94.50 |
| Total | 94.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002004 | 2 Feb 2026 | 523.00 | CASCADE CARE | Not denied | — |
| CLM0002003 | 12 Sep 2025 | 630.00 | CASCADE CARE | Not denied | — |
| CLM0002005 | 4 Sep 2024 | 679.00 | CASCADE CARE | Not denied | — |