BRIAN EVANS
Subscriber on policy B04M000073
Claims
3
Attributed to this person
Charged
1,207.00
Total submitted
Denied
845.00
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 | BRIAN EVANS |
| Role on the policy | Subscriber |
| Policy | B04M000073 |
| Date of birth | 24 Apr 1977 |
| Plan | SILVER HMO |
| Covered from | 3 Nov 2024 |
| Covered to | 28 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000344 | 8 Apr 2025 | 362.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000343 | 23 Dec 2024 | 96.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 96.00 |
| CLM0000345 | 6 Nov 2024 | 749.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 749.00 |