LEILA EVANS
Subscriber on policy B07M000317
Claims
3
Attributed to this person
Charged
1,983.00
Total submitted
Denied
743.00
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 | LEILA EVANS |
| Role on the policy | Subscriber |
| Policy | B07M000317 |
| Date of birth | 17 Jul 1951 |
| Plan | PLATINUM PPO |
| Covered from | 8 Jan 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 |
|---|---|---|---|---|---|
| CLM0001368 | 16 Jun 2026 | 548.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001367 | 22 Aug 2024 | 743.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 743.00 |
| CLM0001369 | 16 Mar 2024 | 692.00 | NORTHSTAR MUTUAL | Not denied | — |