VICTOR SMITH
Subscriber on policy B07M000534
Claims
3
Attributed to this person
Charged
2,035.00
Total submitted
Denied
102.62
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 | VICTOR SMITH |
| Role on the policy | Subscriber |
| Policy | B07M000534 |
| Date of birth | 5 Nov 1989 |
| Plan | GOLD PPO |
| Covered from | 12 Jan 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 |
|---|---|---|---|---|---|
| CLM0002276 | 17 Aug 2026 | 739.00 | CASCADE CARE | Not denied | — |
| CLM0002275 | 29 May 2025 | 838.00 | CASCADE CARE | Not denied | — |
| CLM0002274 | 3 Jan 2025 | 458.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 102.62 |