OMAR NGUYEN
Dependent on policy B06M000423
Claims
3
Attributed to this person
Charged
988.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
129.60
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 | OMAR NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000423 |
| Date of birth | 10 Jun 1964 |
| Plan | BRONZE EPO |
| Covered from | 7 Oct 2024 |
| Covered to | 5 Jun 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 129.60 |
| Total | 129.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001941 | 27 Apr 2025 | 197.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001942 | 19 Apr 2025 | 648.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001940 | 28 Oct 2024 | 143.00 | MERIDIAN HEALTH PLAN | Not denied | — |