OMAR CHEN
Subscriber on policy B01M000011
Claims
1
Attributed to this person
Charged
263.00
Total submitted
Denied
263.00
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 | OMAR CHEN |
| Role on the policy | Subscriber |
| Policy | B01M000011 |
| Date of birth | 10 Dec 1976 |
| Plan | BRONZE EPO |
| Covered from | 29 Mar 2025 |
| Covered to | 27 Oct 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 |
|---|---|---|---|---|---|
| CLM0000036 | 21 Mar 2025 | 263.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 263.00 |