ZARA EVANS
Subscriber on policy B08M000745
Claims
1
Attributed to this person
Charged
341.00
Total submitted
Denied
341.00
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 | ZARA EVANS |
| Role on the policy | Subscriber |
| Policy | B08M000745 |
| Date of birth | 4 Jun 1955 |
| Plan | GOLD PPO |
| Covered from | 15 Apr 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 |
|---|---|---|---|---|---|
| CLM0003337 | 23 Oct 2025 | 341.00 | CASCADE CARE | CARC 109 · COB | 341.00 |