JULIA SMITH
Dependent on policy B08M000285
Claims
3
Attributed to this person
Charged
864.00
Total submitted
Denied
258.33
2 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 19 |
| Policy | B08M000285 |
| Date of birth | 13 Jan 2006 |
| Plan | BRONZE EPO |
| Covered from | 20 Oct 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 |
|---|---|---|---|---|---|
| CLM0001305 | 23 May 2026 | 291.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001307 | 21 Sep 2025 | 143.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 143.00 |
| CLM0001306 | 15 Jan 2025 | 430.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 115.33 |