YUSUF CHEN
Dependent on policy B03M000357
Claims
3
Attributed to this person
Charged
862.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
141.05
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 | YUSUF CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000357 |
| Date of birth | 7 Sep 2017 |
| Plan | SILVER HMO |
| Covered from | 14 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 141.05 |
| Total | 141.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001438 | 4 Jun 2025 | 544.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001436 | 18 Jan 2025 | 217.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0001437 | 24 Apr 2024 | 101.00 | MERIDIAN HEALTH PLAN | Not denied | — |