WENDY EVANS
Dependent on policy B07M000452
Claims
2
Attributed to this person
Charged
1,076.00
Total submitted
Denied
458.00
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 | Dependent · relationship 01 |
| Policy | B07M000452 |
| Date of birth | 9 May 2008 |
| Plan | SILVER HMO |
| Covered from | 5 Jul 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 |
|---|---|---|---|---|---|
| CLM0001909 | 5 Jan 2026 | 618.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001910 | 10 Aug 2024 | 458.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 458.00 |