PRIYA EVANS
Subscriber on policy B06M000634
Claims
1
Attributed to this person
Charged
422.00
Total submitted
Denied
422.00
1 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 | B06M000634 |
| Date of birth | 4 Oct 1967 |
| Plan | BRONZE EPO |
| Covered from | 4 Feb 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 |
|---|---|---|---|---|---|
| CLM0002833 | 1 Apr 2026 | 422.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 422.00 |