IVAN CHEN
Subscriber on policy B07M000564
Claims
2
Attributed to this person
Charged
1,030.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
134.20
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 | IVAN CHEN |
| Role on the policy | Subscriber |
| Policy | B07M000564 |
| Date of birth | 14 May 1987 |
| Plan | PLATINUM PPO |
| Covered from | 24 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 134.20 |
| Total | 134.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002390 | 26 May 2026 | 359.00 | CASCADE CARE | Not denied | — |
| CLM0002389 | 15 Feb 2025 | 671.00 | CASCADE CARE | Not denied | — |