UMA EVANS
Dependent on policy B06M000659
Claims
1
Attributed to this person
Charged
190.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
38.00
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 | UMA EVANS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000659 |
| Date of birth | 9 Jul 1990 |
| Plan | PLATINUM PPO |
| Covered from | 30 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 38.00 |
| Total | 38.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002913 | 11 Aug 2026 | 190.00 | MERIDIAN HEALTH PLAN | Not denied | — |