VICTOR CHEN
Dependent on policy B02M000418
Claims
3
Attributed to this person
Charged
1,992.00
Total submitted
Denied
249.81
1 denied claims
Patient responsibility
116.20
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 | VICTOR CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000418 |
| Date of birth | 3 Dec 1964 |
| Plan | GOLD PPO |
| Covered from | 21 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 116.20 |
| Total | 116.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001785 | 23 Feb 2026 | 709.00 | CASCADE CARE | Not denied | — |
| CLM0001786 | 26 Jan 2026 | 702.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 249.81 |
| CLM0001787 | 13 Jan 2025 | 581.00 | CASCADE CARE | Not denied | — |