MARCUS EVANS
Dependent on policy B03M000792
Claims
3
Attributed to this person
Charged
1,738.00
Total submitted
Denied
356.00
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 | MARCUS EVANS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000792 |
| Date of birth | 28 Jul 1988 |
| Plan | SILVER HMO |
| Covered from | 27 Nov 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0003374 | 18 Sep 2025 | 356.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 356.00 |
| CLM0003376 | 14 Jun 2025 | 780.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003375 | 1 Dec 2024 | 602.00 | NORTHSTAR MUTUAL | Not denied | — |