RAVI CHEN
Dependent on policy B07M000382
Claims
2
Attributed to this person
Charged
817.00
Total submitted
Denied
29.27
1 denied claims
Patient responsibility
142.60
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 | RAVI CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000382 |
| Date of birth | 5 Jun 2023 |
| Plan | SILVER HMO |
| Covered from | 5 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 142.60 |
| Total | 142.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001630 | 21 Jul 2026 | 104.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 29.27 |
| CLM0001629 | 12 Nov 2025 | 713.00 | MERIDIAN HEALTH PLAN | Not denied | — |