SOFIA CHEN
Dependent on policy B06M000339
Claims
1
Attributed to this person
Charged
160.00
Total submitted
Denied
160.00
1 denied claims
Patient responsibility
0.00
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 CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000339 |
| Date of birth | 1 Mar 2018 |
| Plan | GOLD PPO |
| Covered from | 3 Dec 2024 |
| Covered to | 1 Jul 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001538 | 13 Nov 2024 | 160.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 160.00 |