ELENA EVANS
Dependent on policy B07M000265
Claims
3
Attributed to this person
Charged
725.00
Total submitted
Denied
543.00
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 | ELENA EVANS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000265 |
| Date of birth | 16 Apr 2004 |
| Plan | PLATINUM PPO |
| Covered from | 20 Oct 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0001142 | 15 Apr 2026 | 62.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001143 | 11 Oct 2025 | 120.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001144 | 18 Aug 2025 | 543.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 543.00 |