BRIAN CHEN
Dependent on policy B06M000004
Claims
3
Attributed to this person
Charged
1,969.00
Total submitted
Denied
439.00
2 denied claims
Patient responsibility
461.50
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 | BRIAN CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000004 |
| Date of birth | 19 Feb 2022 |
| Plan | GOLD PPO |
| Covered from | 12 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 461.50 |
| Total | 461.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000024 | 16 Mar 2026 | 710.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000026 | 26 Oct 2025 | 820.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000025 | 4 May 2024 | 439.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 439.00 |