JULIA EVANS
Dependent on policy B08M000570
Claims
2
Attributed to this person
Charged
1,653.00
Total submitted
Denied
236.73
1 denied claims
Patient responsibility
178.00
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 | JULIA EVANS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000570 |
| Date of birth | 20 Mar 2002 |
| Plan | BRONZE EPO |
| Covered from | 26 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 178.00 |
| Total | 178.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002607 | 8 Jun 2026 | 890.00 | CASCADE CARE | Not denied | — |
| CLM0002606 | 5 Dec 2024 | 763.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 236.73 |