LEILA EVANS
Dependent on policy B03M000432
Claims
3
Attributed to this person
Charged
1,274.00
Total submitted
Denied
1,146.00
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 | LEILA EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000432 |
| Date of birth | 13 Feb 1990 |
| Plan | BRONZE EPO |
| Covered from | 23 Jan 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 |
|---|---|---|---|---|---|
| CLM0001763 | 8 Aug 2026 | 847.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 847.00 |
| CLM0001762 | 6 Jan 2026 | 299.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 299.00 |
| CLM0001761 | 26 Dec 2025 | 128.00 | MERIDIAN HEALTH PLAN | Not denied | — |