NADIA EVANS
Subscriber on policy B04M000707
Claims
2
Attributed to this person
Charged
737.00
Total submitted
Denied
658.00
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 | NADIA EVANS |
| Role on the policy | Subscriber |
| Policy | B04M000707 |
| Date of birth | 23 Mar 1951 |
| Plan | PLATINUM PPO |
| Covered from | 11 Apr 2024 |
| Covered to | 24 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003078 | 8 Jul 2024 | 79.00 | CASCADE CARE | Not denied | — |
| CLM0003077 | 23 Mar 2024 | 658.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 658.00 |