DAVID EVANS
Dependent on policy B06M000181
Claims
3
Attributed to this person
Charged
1,401.00
Total submitted
Denied
290.00
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 | DAVID EVANS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000181 |
| Date of birth | 21 Mar 1971 |
| Plan | GOLD PPO |
| Covered from | 28 Jul 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 |
|---|---|---|---|---|---|
| CLM0000882 | 15 Oct 2025 | 258.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000883 | 8 Jul 2025 | 853.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000884 | 26 Aug 2024 | 290.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 290.00 |