SOFIA CHEN
Dependent on policy B10M000103
Claims
1
Attributed to this person
Charged
113.00
Total submitted
Denied
28.95
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 | SOFIA CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000103 |
| Date of birth | 2 Apr 2017 |
| Plan | SILVER HMO |
| Covered from | 14 Feb 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 |
|---|---|---|---|---|---|
| CLM0000424 | 28 Apr 2026 | 113.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 28.95 |