FIONA EVANS
Dependent on policy B05M000041
Claims
1
Attributed to this person
Charged
792.00
Total submitted
Denied
792.00
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 | B05M000041 |
| Date of birth | 18 Feb 1959 |
| Plan | PLATINUM PPO |
| Covered from | 18 May 2025 |
| Covered to | 9 Mar 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000182 | 20 Apr 2026 | 792.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 792.00 |