LEILA SMITH
Subscriber on policy B06M000816
Claims
3
Attributed to this person
Charged
1,815.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
90.45
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 | Subscriber |
| Policy | B06M000816 |
| Date of birth | 14 Aug 1972 |
| Plan | PLATINUM PPO |
| Covered from | 29 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 90.45 |
| Total | 90.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003581 | 13 Feb 2026 | 374.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003583 | 31 Oct 2025 | 838.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003582 | 8 Mar 2025 | 603.00 | MERIDIAN HEALTH PLAN | Not denied | — |