GRACE CHEN
Subscriber on policy B04M000887
Claims
3
Attributed to this person
Charged
1,462.00
Total submitted
Denied
801.00
2 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 | B04M000887 |
| Date of birth | 26 Jun 1987 |
| Plan | PLATINUM PPO |
| Covered from | 9 Jun 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 |
|---|---|---|---|---|---|
| CLM0003835 | 10 Apr 2026 | 719.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 719.00 |
| CLM0003836 | 21 Sep 2025 | 82.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 82.00 |
| CLM0003837 | 19 Dec 2024 | 661.00 | MERIDIAN HEALTH PLAN | Not denied | — |