KEVIN CHEN
Dependent on policy B10M000159
Claims
3
Attributed to this person
Charged
997.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
80.40
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 | KEVIN CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000159 |
| Date of birth | 22 Sep 2007 |
| Plan | PLATINUM PPO |
| Covered from | 17 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 80.40 |
| Total | 80.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000653 | 25 May 2026 | 79.00 | CASCADE CARE | Not denied | — |
| CLM0000651 | 18 Jul 2025 | 536.00 | CASCADE CARE | Not denied | — |
| CLM0000652 | 17 Sep 2024 | 382.00 | CASCADE CARE | Not denied | — |