ZARA EVANS
Subscriber on policy B07M000101
Claims
3
Attributed to this person
Charged
985.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
208.00
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 | ZARA EVANS |
| Role on the policy | Subscriber |
| Policy | B07M000101 |
| Date of birth | 30 Apr 1977 |
| Plan | SILVER HMO |
| Covered from | 24 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 208.00 |
| Total | 208.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000415 | 4 Aug 2026 | 232.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000416 | 24 Jan 2026 | 320.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000414 | 16 Dec 2025 | 433.00 | MERIDIAN HEALTH PLAN | Not denied | — |