BRIAN SMITH
Subscriber on policy B09M000486
Claims
2
Attributed to this person
Charged
765.00
Total submitted
Denied
765.00
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 | BRIAN SMITH |
| Role on the policy | Subscriber |
| Policy | B09M000486 |
| Date of birth | 31 Aug 1993 |
| Plan | PLATINUM PPO |
| Covered from | 21 Sep 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 |
|---|---|---|---|---|---|
| CLM0002044 | 13 Apr 2026 | 364.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 364.00 |
| CLM0002045 | 23 Nov 2025 | 401.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 401.00 |