DAVID SMITH
Subscriber on policy B06M000719
Claims
3
Attributed to this person
Charged
1,562.00
Total submitted
Denied
1,083.00
2 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 SMITH |
| Role on the policy | Subscriber |
| Policy | B06M000719 |
| Date of birth | 23 Apr 1953 |
| Plan | SILVER HMO |
| Covered from | 27 Sep 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 |
|---|---|---|---|---|---|
| CLM0003217 | 10 Feb 2026 | 816.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 816.00 |
| CLM0003215 | 30 Sep 2025 | 267.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 267.00 |
| CLM0003216 | 24 Aug 2025 | 479.00 | MERIDIAN HEALTH PLAN | Not denied | — |