LEILA SMITH
Dependent on policy B06M000717
Claims
3
Attributed to this person
Charged
967.00
Total submitted
Denied
96.00
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 | LEILA SMITH |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000717 |
| Date of birth | 22 Apr 1983 |
| Plan | PLATINUM PPO |
| Covered from | 23 Mar 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 |
|---|---|---|---|---|---|
| CLM0003209 | 28 Nov 2025 | 96.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 96.00 |
| CLM0003208 | 20 Dec 2024 | 503.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003207 | 2 Jun 2024 | 368.00 | MERIDIAN HEALTH PLAN | Not denied | — |