JULIA EVANS
Subscriber on policy B08M000763
Claims
1
Attributed to this person
Charged
293.00
Total submitted
Denied
293.00
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 | JULIA EVANS |
| Role on the policy | Subscriber |
| Policy | B08M000763 |
| Date of birth | 23 Jun 1965 |
| Plan | SILVER HMO |
| Covered from | 12 Feb 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0003410 | 2 Jan 2025 | 293.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 293.00 |