AMARA EVANS
Dependent on policy B03M000401
Claims
1
Attributed to this person
Charged
857.00
Total submitted
Denied
857.00
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 | AMARA EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000401 |
| Date of birth | 1 Feb 2008 |
| Plan | SILVER HMO |
| Covered from | 10 Jun 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001634 | 18 Jun 2025 | 857.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 857.00 |