JULIA CHEN
Subscriber on policy B09M000423
Claims
1
Attributed to this person
Charged
566.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
367.90
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 | JULIA CHEN |
| Role on the policy | Subscriber |
| Policy | B09M000423 |
| Date of birth | 22 Sep 1980 |
| Plan | BRONZE EPO |
| Covered from | 23 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 367.90 |
| Total | 367.90 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001764 | 26 Apr 2026 | 566.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |