LEILA EVANS
Dependent on policy B01M000584
Claims
3
Attributed to this person
Charged
1,904.00
Total submitted
Denied
648.00
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 | LEILA EVANS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000584 |
| Date of birth | 19 Oct 1985 |
| Plan | GOLD PPO |
| Covered from | 9 Feb 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 |
|---|---|---|---|---|---|
| CLM0002610 | 3 Jul 2026 | 648.00 | CASCADE CARE | CARC 18 · DUPLICATE | 648.00 |
| CLM0002609 | 18 Sep 2025 | 616.00 | CASCADE CARE | Not denied | — |
| CLM0002608 | 18 May 2025 | 640.00 | CASCADE CARE | Not denied | — |