JULIA SMITH
Dependent on policy B01M000127
Claims
3
Attributed to this person
Charged
1,250.00
Total submitted
Denied
115.21
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 | JULIA SMITH |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000127 |
| Date of birth | 10 Jul 1943 |
| Plan | BRONZE EPO |
| Covered from | 15 May 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 |
|---|---|---|---|---|---|
| CLM0000504 | 24 Mar 2026 | 381.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 115.21 |
| CLM0000503 | 13 Jan 2026 | 486.00 | CASCADE CARE | Not denied | — |
| CLM0000505 | 1 Jan 2026 | 383.00 | CASCADE CARE | Not denied | — |