RAVI EVANS
Dependent on policy B05M000041
Claims
1
Attributed to this person
Charged
678.00
Total submitted
Denied
0.00
0 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 | RAVI EVANS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000041 |
| Date of birth | 22 Feb 2000 |
| 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 |
|---|---|---|---|---|---|
| CLM0000183 | 18 Jun 2025 | 678.00 | CASCADE CARE | Not denied | — |