DAVID SMITH
Subscriber on policy B07M000470
Claims
3
Attributed to this person
Charged
1,144.00
Total submitted
Denied
235.47
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 | DAVID SMITH |
| Role on the policy | Subscriber |
| Policy | B07M000470 |
| Date of birth | 14 Sep 1965 |
| Plan | SILVER HMO |
| Covered from | 7 Apr 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001994 | 15 Aug 2026 | 334.00 | CASCADE CARE | Not denied | — |
| CLM0001995 | 9 Dec 2025 | 214.00 | CASCADE CARE | Not denied | — |
| CLM0001993 | 18 Oct 2025 | 596.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 235.47 |