WENDY EVANS
Subscriber on policy B01M000757
Claims
2
Attributed to this person
Charged
1,326.00
Total submitted
Denied
837.00
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 | WENDY EVANS |
| Role on the policy | Subscriber |
| Policy | B01M000757 |
| Date of birth | 26 Apr 1999 |
| Plan | GOLD PPO |
| Covered from | 20 May 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 |
|---|---|---|---|---|---|
| CLM0003369 | 30 Sep 2025 | 837.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 837.00 |
| CLM0003368 | 26 Aug 2025 | 489.00 | NORTHSTAR MUTUAL | Not denied | — |