RAVI SMITH
Dependent on policy B08M000396
Claims
2
Attributed to this person
Charged
710.00
Total submitted
Denied
486.42
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 | RAVI SMITH |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000396 |
| Date of birth | 16 Dec 1952 |
| Plan | GOLD PPO |
| Covered from | 17 Jan 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 |
|---|---|---|---|---|---|
| CLM0001805 | 29 Nov 2025 | 361.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 361.00 |
| CLM0001806 | 13 Aug 2025 | 349.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 125.42 |