IVAN SMITH
Dependent on policy B09M000647
Claims
3
Attributed to this person
Charged
932.00
Total submitted
Denied
774.00
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 | IVAN SMITH |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000647 |
| Date of birth | 12 Aug 1959 |
| Plan | PLATINUM PPO |
| Covered from | 17 Apr 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 |
|---|---|---|---|---|---|
| CLM0002749 | 2 Aug 2026 | 339.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 339.00 |
| CLM0002748 | 10 Dec 2024 | 435.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 435.00 |
| CLM0002747 | 4 Sep 2024 | 158.00 | MERIDIAN HEALTH PLAN | Not denied | — |