ELENA CHEN
Dependent on policy B01M000488
Claims
1
Attributed to this person
Charged
428.00
Total submitted
Denied
0.00
0 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 | ELENA CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000488 |
| Date of birth | 10 Jul 1997 |
| Plan | BRONZE EPO |
| Covered from | 13 Jun 2025 |
| Covered to | 11 Oct 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002175 | 14 Sep 2025 | 428.00 | MERIDIAN HEALTH PLAN | Not denied | — |