ELENA EVANS
Subscriber on policy B02M000691
Claims
1
Attributed to this person
Charged
503.00
Total submitted
Denied
0.00
0 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 | ELENA EVANS |
| Role on the policy | Subscriber |
| Policy | B02M000691 |
| Date of birth | 11 Apr 1986 |
| Plan | SILVER HMO |
| Covered from | 23 Feb 2025 |
| Covered to | 15 Jul 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 |
|---|---|---|---|---|---|
| CLM0002908 | 6 May 2025 | 503.00 | MERIDIAN HEALTH PLAN | Not denied | — |