UMA EVANS
Subscriber on policy B02M000112
Claims
3
Attributed to this person
Charged
1,228.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
11.85
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 | UMA EVANS |
| Role on the policy | Subscriber |
| Policy | B02M000112 |
| Date of birth | 17 Aug 1999 |
| Plan | BRONZE EPO |
| Covered from | 8 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 11.85 |
| Total | 11.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000508 | 28 Nov 2025 | 533.00 | CASCADE CARE | Not denied | — |
| CLM0000506 | 15 Oct 2025 | 79.00 | CASCADE CARE | Not denied | — |
| CLM0000507 | 25 Feb 2025 | 616.00 | CASCADE CARE | Not denied | — |