NADIA EVANS
Dependent on policy B10M000167
Claims
2
Attributed to this person
Charged
701.00
Total submitted
Denied
492.00
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 | NADIA EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000167 |
| Date of birth | 21 Aug 2000 |
| Plan | SILVER HMO |
| Covered from | 25 May 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 |
|---|---|---|---|---|---|
| CLM0000701 | 16 Nov 2025 | 492.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 492.00 |
| CLM0000700 | 30 Oct 2024 | 209.00 | NORTHSTAR MUTUAL | Not denied | — |