LEILA CHEN
Subscriber on policy B10M000084
Claims
3
Attributed to this person
Charged
1,693.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
25.00
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 | LEILA CHEN |
| Role on the policy | Subscriber |
| Policy | B10M000084 |
| Date of birth | 1 Jun 1976 |
| Plan | PLATINUM PPO |
| Covered from | 24 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000348 | 27 Jun 2026 | 601.00 | CASCADE CARE | Not denied | — |
| CLM0000349 | 5 Apr 2026 | 522.00 | CASCADE CARE | Not denied | — |
| CLM0000347 | 10 Sep 2025 | 570.00 | CASCADE CARE | Not denied | — |