CARLA CHEN
Subscriber on policy B07M000152
Claims
3
Attributed to this person
Charged
1,939.00
Total submitted
Denied
218.56
1 denied claims
Patient responsibility
109.00
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 | CARLA CHEN |
| Role on the policy | Subscriber |
| Policy | B07M000152 |
| Date of birth | 24 Sep 1952 |
| Plan | SILVER HMO |
| Covered from | 14 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 109.00 |
| Total | 109.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000625 | 27 Jun 2026 | 598.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000623 | 12 Dec 2025 | 545.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000624 | 25 May 2025 | 796.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 218.56 |