LEILA EVANS
Dependent on policy B10M000220
Claims
2
Attributed to this person
Charged
794.00
Total submitted
Denied
716.00
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 | B10M000220 |
| Date of birth | 1 Jan 2001 |
| Plan | SILVER HMO |
| Covered from | 20 Jun 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 |
|---|---|---|---|---|---|
| CLM0000907 | 2 May 2026 | 78.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000908 | 22 Mar 2026 | 716.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 716.00 |