GRACE CHEN
Subscriber on policy B04M000811
Claims
3
Attributed to this person
Charged
1,199.00
Total submitted
Denied
380.00
1 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 | GRACE CHEN |
| Role on the policy | Subscriber |
| Policy | B04M000811 |
| Date of birth | 12 Apr 1959 |
| Plan | SILVER HMO |
| Covered from | 19 Feb 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0003536 | 15 Jul 2026 | 498.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003537 | 6 Jun 2025 | 380.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 380.00 |
| CLM0003538 | 14 Apr 2025 | 321.00 | MERIDIAN HEALTH PLAN | Not denied | — |