IVAN SMITH
Dependent on policy B07M000291
Claims
1
Attributed to this person
Charged
495.00
Total submitted
Denied
0.00
0 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 | IVAN SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000291 |
| Date of birth | 5 Aug 2022 |
| Plan | BRONZE EPO |
| Covered from | 22 Aug 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 |
|---|---|---|---|---|---|
| CLM0001264 | 20 Jan 2025 | 495.00 | MERIDIAN HEALTH PLAN | Not denied | — |