BRIAN EVANS
Subscriber on policy B08M000550
Claims
3
Attributed to this person
Charged
1,283.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
25.00
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 | BRIAN EVANS |
| Role on the policy | Subscriber |
| Policy | B08M000550 |
| Date of birth | 25 Aug 1986 |
| Plan | BRONZE EPO |
| Covered from | 13 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002519 | 29 Jun 2026 | 740.00 | CASCADE CARE | Not denied | — |
| CLM0002520 | 21 Dec 2025 | 461.00 | CASCADE CARE | Not denied | — |
| CLM0002521 | 2 Jul 2025 | 82.00 | CASCADE CARE | Not denied | — |