AMARA CHEN
Dependent on policy B05M000160
Claims
2
Attributed to this person
Charged
459.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
55.50
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 | B05M000160 |
| Date of birth | 4 Sep 1959 |
| Plan | PLATINUM PPO |
| Covered from | 5 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 55.50 |
| Total | 55.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000667 | 1 Oct 2025 | 89.00 | CASCADE CARE | Not denied | — |
| CLM0000666 | 21 Nov 2024 | 370.00 | CASCADE CARE | Not denied | — |