SOFIA CHEN
Dependent on policy B05M000332
Claims
3
Attributed to this person
Charged
1,046.00
Total submitted
Denied
75.00
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 | SOFIA CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000332 |
| Date of birth | 16 Sep 1962 |
| Plan | GOLD PPO |
| Covered from | 4 Nov 2024 |
| Covered to | 10 May 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 |
|---|---|---|---|---|---|
| CLM0001401 | 28 Feb 2025 | 290.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001402 | 18 Jan 2025 | 681.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001400 | 2 Jan 2025 | 75.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 75.00 |