FIONA EVANS
Dependent on policy B02M000447
Claims
3
Attributed to this person
Charged
1,253.00
Total submitted
Denied
459.67
2 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 | B02M000447 |
| Date of birth | 21 Jan 1974 |
| Plan | PLATINUM PPO |
| Covered from | 24 Jun 2025 |
| Covered to | 21 Dec 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 |
|---|---|---|---|---|---|
| CLM0001906 | 14 Feb 2026 | 403.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 403.00 |
| CLM0001905 | 13 Sep 2025 | 209.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 56.67 |
| CLM0001904 | 11 Jul 2025 | 641.00 | CASCADE CARE | Not denied | — |