FIONA EVANS
Dependent on policy B09M000846
Claims
1
Attributed to this person
Charged
876.00
Total submitted
Denied
176.60
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 | FIONA EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000846 |
| Date of birth | 30 Oct 1969 |
| Plan | BRONZE EPO |
| Covered from | 18 Jan 2025 |
| Covered to | 1 Aug 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003597 | 25 Jul 2025 | 876.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 176.60 |