UMA EVANS
Subscriber on policy B07M000824
Claims
2
Attributed to this person
Charged
982.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
84.30
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 | UMA EVANS |
| Role on the policy | Subscriber |
| Policy | B07M000824 |
| Date of birth | 2 Sep 1997 |
| Plan | GOLD PPO |
| Covered from | 8 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 84.30 |
| Total | 84.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003373 | 18 Mar 2026 | 562.00 | CASCADE CARE | Not denied | — |
| CLM0003374 | 29 May 2024 | 420.00 | CASCADE CARE | Not denied | — |