UMA SMITH
Dependent on policy B08M000538
Claims
2
Attributed to this person
Charged
954.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
97.50
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 | UMA SMITH |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000538 |
| Date of birth | 27 Sep 1942 |
| Plan | SILVER HMO |
| Covered from | 8 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 97.50 |
| Total | 97.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002468 | 13 Aug 2025 | 650.00 | CASCADE CARE | Not denied | — |
| CLM0002467 | 1 Aug 2024 | 304.00 | CASCADE CARE | Not denied | — |