NADIA EVANS
Dependent on policy B08M000229
Claims
2
Attributed to this person
Charged
993.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
118.65
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 | NADIA EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000229 |
| Date of birth | 8 Apr 1961 |
| Plan | PLATINUM PPO |
| Covered from | 13 Feb 2024 |
| Covered to | 4 Sep 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 118.65 |
| Total | 118.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001032 | 27 Sep 2024 | 791.00 | CASCADE CARE | Not denied | — |
| CLM0001033 | 12 Jul 2024 | 202.00 | CASCADE CARE | Not denied | — |