NADIA EVANS
Dependent on policy B04M000840
Claims
2
Attributed to this person
Charged
817.00
Total submitted
Denied
361.15
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 | NADIA EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000840 |
| Date of birth | 9 Nov 1964 |
| Plan | PLATINUM PPO |
| Covered from | 17 Dec 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 |
|---|---|---|---|---|---|
| CLM0003630 | 24 Feb 2026 | 750.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 294.15 |
| CLM0003631 | 13 Jun 2025 | 67.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 67.00 |