MARCUS SMITH
Dependent on policy B07M000232
Claims
1
Attributed to this person
Charged
468.00
Total submitted
Denied
468.00
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 | MARCUS SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000232 |
| Date of birth | 12 Sep 1996 |
| Plan | SILVER HMO |
| Covered from | 5 Oct 2024 |
| Covered to | 18 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000982 | 16 Sep 2024 | 468.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 468.00 |