NADIA EVANS
Subscriber on policy B06M000640
Claims
1
Attributed to this person
Charged
768.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
30.00
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 | NADIA EVANS |
| Role on the policy | Subscriber |
| Policy | B06M000640 |
| Date of birth | 3 Mar 1969 |
| Plan | BRONZE EPO |
| Covered from | 26 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002849 | 11 Feb 2026 | 768.00 | NORTHSTAR MUTUAL | Not denied | — |