BRIAN SMITH
Subscriber on policy B08M000125
Claims
3
Attributed to this person
Charged
1,668.00
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 | BRIAN SMITH |
| Role on the policy | Subscriber |
| Policy | B08M000125 |
| Date of birth | 26 Oct 1952 |
| Plan | BRONZE EPO |
| Covered from | 24 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 |
|---|---|---|---|---|---|
| CLM0000566 | 24 Dec 2025 | 258.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000564 | 15 May 2025 | 620.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000565 | 30 Jan 2025 | 790.00 | NORTHSTAR MUTUAL | Not denied | — |