DAVID CHEN
Dependent on policy B10M000190
Claims
2
Attributed to this person
Charged
527.00
Total submitted
Denied
527.00
2 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 | DAVID CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000190 |
| Date of birth | 1 Apr 2009 |
| Plan | PLATINUM PPO |
| Covered from | 31 May 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 |
|---|---|---|---|---|---|
| CLM0000788 | 21 Nov 2025 | 135.00 | CASCADE CARE | CARC 11 · CODING | 135.00 |
| CLM0000789 | 8 May 2025 | 392.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 392.00 |