SOFIA NGUYEN
Subscriber on policy B06M000066
Claims
2
Attributed to this person
Charged
643.00
Total submitted
Denied
568.00
1 denied claims
Patient responsibility
20.00
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 | Subscriber |
| Policy | B06M000066 |
| Date of birth | 14 Oct 1962 |
| Plan | BRONZE EPO |
| Covered from | 16 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000355 | 5 Feb 2026 | 568.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 568.00 |
| CLM0000354 | 5 Jun 2025 | 75.00 | MERIDIAN HEALTH PLAN | Not denied | — |