BRIAN EVANS
Dependent on policy B03M000472
Claims
2
Attributed to this person
Charged
734.00
Total submitted
Denied
148.00
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 | BRIAN EVANS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000472 |
| Date of birth | 5 Mar 1989 |
| Plan | PLATINUM PPO |
| Covered from | 15 May 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 |
|---|---|---|---|---|---|
| CLM0001974 | 29 Jan 2026 | 148.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 148.00 |
| CLM0001973 | 30 Dec 2025 | 586.00 | MERIDIAN HEALTH PLAN | Not denied | — |