ZARA SMITH
Subscriber on policy B09M000609
Claims
1
Attributed to this person
Charged
676.00
Total submitted
Denied
303.44
1 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 | ZARA SMITH |
| Role on the policy | Subscriber |
| Policy | B09M000609 |
| Date of birth | 20 Sep 1952 |
| Plan | PLATINUM PPO |
| Covered from | 25 Feb 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 |
|---|---|---|---|---|---|
| CLM0002564 | 22 Mar 2026 | 676.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 303.44 |