FIONA EVANS
Dependent on policy B05M000429
Claims
1
Attributed to this person
Charged
95.00
Total submitted
Denied
95.00
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 | FIONA EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000429 |
| Date of birth | 26 Oct 1975 |
| 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 |
|---|---|---|---|---|---|
| CLM0001808 | 8 Dec 2024 | 95.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 95.00 |