ELENA CHEN
Subscriber on policy B10M000188
Claims
2
Attributed to this person
Charged
1,475.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
121.35
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 | ELENA CHEN |
| Role on the policy | Subscriber |
| Policy | B10M000188 |
| Date of birth | 1 Oct 1992 |
| Plan | PLATINUM PPO |
| Covered from | 7 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 121.35 |
| Total | 121.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000773 | 11 Sep 2025 | 666.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000772 | 8 Aug 2025 | 809.00 | MERIDIAN HEALTH PLAN | Not denied | — |