NADIA SMITH
Subscriber on policy B09M000146
Claims
2
Attributed to this person
Charged
988.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
354.20
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 | NADIA SMITH |
| Role on the policy | Subscriber |
| Policy | B09M000146 |
| Date of birth | 16 May 2000 |
| Plan | PLATINUM PPO |
| Covered from | 18 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 267.80 |
| CARC 1 · Deductible | 1 | 86.40 |
| Total | 354.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000614 | 5 May 2026 | 412.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000613 | 8 Feb 2026 | 576.00 | MERIDIAN HEALTH PLAN | Not denied | — |