CARLA CHEN
Dependent on policy B07M000763
Claims
2
Attributed to this person
Charged
925.00
Total submitted
Denied
303.05
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 | CARLA CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000763 |
| Date of birth | 30 Nov 2001 |
| Plan | PLATINUM PPO |
| Covered from | 1 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003169 | 15 Jan 2026 | 681.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 303.05 |
| CLM0003168 | 25 Dec 2024 | 244.00 | MERIDIAN HEALTH PLAN | Not denied | — |