UMA CHEN
Dependent on policy B10M000155
Claims
1
Attributed to this person
Charged
385.00
Total submitted
Denied
385.00
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 | UMA CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000155 |
| Date of birth | 18 Apr 1967 |
| Plan | GOLD PPO |
| Covered from | 22 May 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0000628 | 21 Oct 2024 | 385.00 | CASCADE CARE | CARC 18 · DUPLICATE | 385.00 |