BRIAN SMITH
Subscriber on policy B09M000113
Claims
2
Attributed to this person
Charged
757.00
Total submitted
Denied
0.00
0 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 | B09M000113 |
| Date of birth | 18 Feb 1973 |
| Plan | SILVER HMO |
| Covered from | 30 Nov 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 |
|---|---|---|---|---|---|
| CLM0000463 | 12 May 2026 | 556.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000462 | 19 Oct 2025 | 201.00 | NORTHSTAR MUTUAL | Not denied | — |