UMA NGUYEN
Dependent on policy B06M000409
Claims
3
Attributed to this person
Charged
1,224.00
Total submitted
Denied
431.00
2 denied claims
Patient responsibility
158.60
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 | UMA NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000409 |
| Date of birth | 9 Apr 1952 |
| Plan | GOLD PPO |
| Covered from | 22 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 158.60 |
| Total | 158.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001871 | 15 Aug 2026 | 362.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 362.00 |
| CLM0001872 | 4 Apr 2026 | 793.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001870 | 12 Feb 2026 | 69.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 69.00 |