RAVI EVANS
Subscriber on policy B03M000866
Claims
3
Attributed to this person
Charged
1,193.00
Total submitted
Denied
477.15
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 | RAVI EVANS |
| Role on the policy | Subscriber |
| Policy | B03M000866 |
| Date of birth | 6 Mar 1958 |
| Plan | PLATINUM PPO |
| Covered from | 5 Feb 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 |
|---|---|---|---|---|---|
| CLM0003750 | 18 Jul 2026 | 180.00 | CASCADE CARE | Not denied | — |
| CLM0003751 | 18 Jun 2026 | 713.00 | CASCADE CARE | CARC 96 · NON_COVERED | 177.15 |
| CLM0003752 | 25 Mar 2025 | 300.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 300.00 |