KEVIN EVANS
Subscriber on policy B04M000672
Claims
3
Attributed to this person
Charged
1,805.00
Total submitted
Denied
864.00
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 | KEVIN EVANS |
| Role on the policy | Subscriber |
| Policy | B04M000672 |
| Date of birth | 2 Aug 1995 |
| Plan | GOLD PPO |
| Covered from | 3 Jul 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 |
|---|---|---|---|---|---|
| CLM0002932 | 25 May 2026 | 239.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002931 | 30 May 2025 | 864.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 864.00 |
| CLM0002930 | 29 Apr 2025 | 702.00 | MERIDIAN HEALTH PLAN | Not denied | — |