AMARA CHEN
Dependent on policy B04M000887
Claims
3
Attributed to this person
Charged
1,267.00
Total submitted
Denied
856.00
3 denied claims
Patient responsibility
267.15
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 | AMARA CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000887 |
| Date of birth | 30 Nov 1994 |
| Plan | PLATINUM PPO |
| Covered from | 9 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 267.15 |
| Total | 267.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003840 | 7 Apr 2026 | 411.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0003838 | 14 Jun 2025 | 109.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 109.00 |
| CLM0003839 | 27 Dec 2024 | 747.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 747.00 |