WENDY EVANS
Subscriber on policy B02M000800
Claims
2
Attributed to this person
Charged
869.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
96.60
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 | WENDY EVANS |
| Role on the policy | Subscriber |
| Policy | B02M000800 |
| Date of birth | 23 Apr 1956 |
| Plan | SILVER HMO |
| Covered from | 30 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 96.60 |
| Total | 96.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003346 | 24 Dec 2025 | 483.00 | CASCADE CARE | Not denied | — |
| CLM0003347 | 10 Oct 2025 | 386.00 | CASCADE CARE | Not denied | — |