ELENA EVANS
Subscriber on policy B05M000387
Claims
2
Attributed to this person
Charged
1,073.00
Total submitted
Denied
746.00
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 | ELENA EVANS |
| Role on the policy | Subscriber |
| Policy | B05M000387 |
| Date of birth | 17 May 1982 |
| Plan | BRONZE EPO |
| Covered from | 28 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001641 | 28 Apr 2026 | 746.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 746.00 |
| CLM0001640 | 3 Oct 2025 | 327.00 | CASCADE CARE | Not denied | — |