PRIYA EVANS
Subscriber on policy B01M000576
Claims
3
Attributed to this person
Charged
1,248.00
Total submitted
Denied
804.00
2 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 | PRIYA EVANS |
| Role on the policy | Subscriber |
| Policy | B01M000576 |
| Date of birth | 6 Jul 1988 |
| Plan | SILVER HMO |
| Covered from | 3 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002569 | 4 May 2026 | 444.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002567 | 30 Oct 2025 | 91.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 91.00 |
| CLM0002568 | 4 Feb 2025 | 713.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 713.00 |