VICTOR EVANS
Subscriber on policy B05M000429
Claims
2
Attributed to this person
Charged
681.00
Total submitted
Denied
270.00
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 | VICTOR EVANS |
| Role on the policy | Subscriber |
| Policy | B05M000429 |
| Date of birth | 7 Jul 1966 |
| Plan | SILVER HMO |
| Covered from | 1 Jan 2025 |
| Covered to | 12 Mar 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 |
|---|---|---|---|---|---|
| CLM0001806 | 25 Mar 2025 | 270.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 270.00 |
| CLM0001807 | 17 Dec 2024 | 411.00 | MERIDIAN HEALTH PLAN | Not denied | — |