CARLA CHEN
Dependent on policy B06M000172
Claims
2
Attributed to this person
Charged
1,189.00
Total submitted
Denied
595.00
1 denied claims
Patient responsibility
25.00
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 | CARLA CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000172 |
| Date of birth | 17 May 1958 |
| Plan | PLATINUM PPO |
| Covered from | 7 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000846 | 21 Aug 2026 | 594.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000845 | 30 Jan 2026 | 595.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 595.00 |