BRIAN EVANS
Dependent on policy B01M000864
Claims
2
Attributed to this person
Charged
815.00
Total submitted
Denied
224.00
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 01 |
| Policy | B01M000864 |
| Date of birth | 4 Dec 1967 |
| Plan | BRONZE EPO |
| Covered from | 31 Mar 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 |
|---|---|---|---|---|---|
| CLM0003833 | 30 Sep 2025 | 224.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 224.00 |
| CLM0003834 | 5 Sep 2024 | 591.00 | MERIDIAN HEALTH PLAN | Not denied | — |