HENRY EVANS
Dependent on policy B08M000550
Claims
2
Attributed to this person
Charged
1,215.00
Total submitted
Denied
402.00
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 | HENRY EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000550 |
| Date of birth | 15 Feb 1978 |
| Plan | BRONZE EPO |
| Covered from | 13 Mar 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 |
|---|---|---|---|---|---|
| CLM0002522 | 25 Nov 2025 | 813.00 | CASCADE CARE | Not denied | — |
| CLM0002523 | 21 Sep 2025 | 402.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 402.00 |