ELENA EVANS
Subscriber on policy B08M000142
Claims
1
Attributed to this person
Charged
100.00
Total submitted
Denied
100.00
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 | ELENA EVANS |
| Role on the policy | Subscriber |
| Policy | B08M000142 |
| Date of birth | 18 May 1967 |
| Plan | SILVER HMO |
| Covered from | 14 Jan 2025 |
| Covered to | 8 Oct 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000647 | 21 May 2025 | 100.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 100.00 |