IVAN CHEN
Dependent on policy B09M000557
Claims
1
Attributed to this person
Charged
809.00
Total submitted
Denied
270.84
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 | IVAN CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000557 |
| Date of birth | 10 Jan 1986 |
| Plan | GOLD PPO |
| Covered from | 1 Mar 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0002350 | 21 May 2026 | 809.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 270.84 |