RAVI EVANS
Subscriber on policy B08M000375
Claims
3
Attributed to this person
Charged
936.00
Total submitted
Denied
92.22
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 | RAVI EVANS |
| Role on the policy | Subscriber |
| Policy | B08M000375 |
| Date of birth | 13 Nov 1994 |
| Plan | SILVER HMO |
| Covered from | 13 Jan 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 |
|---|---|---|---|---|---|
| CLM0001707 | 16 Jul 2026 | 272.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001709 | 4 May 2026 | 280.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 92.22 |
| CLM0001708 | 18 Dec 2025 | 384.00 | NORTHSTAR MUTUAL | Not denied | — |