AMARA CHEN
Subscriber on policy B01M000872
Claims
2
Attributed to this person
Charged
621.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
87.20
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 | AMARA CHEN |
| Role on the policy | Subscriber |
| Policy | B01M000872 |
| Date of birth | 14 Feb 1969 |
| Plan | GOLD PPO |
| Covered from | 24 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 87.20 |
| Total | 87.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003863 | 17 Dec 2025 | 436.00 | CASCADE CARE | Not denied | — |
| CLM0003862 | 11 Sep 2025 | 185.00 | CASCADE CARE | Not denied | — |