JULIA EVANS
Subscriber on policy B08M000483
Claims
2
Attributed to this person
Charged
1,090.00
Total submitted
Denied
556.00
1 denied claims
Patient responsibility
80.10
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 | JULIA EVANS |
| Role on the policy | Subscriber |
| Policy | B08M000483 |
| Date of birth | 19 Aug 1969 |
| Plan | SILVER HMO |
| Covered from | 19 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 80.10 |
| Total | 80.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002245 | 23 Aug 2025 | 534.00 | CASCADE CARE | Not denied | — |
| CLM0002246 | 27 Jan 2025 | 556.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 556.00 |