YUSUF SMITH
Subscriber on policy B09M000666
Claims
2
Attributed to this person
Charged
1,333.00
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 | YUSUF SMITH |
| Role on the policy | Subscriber |
| Policy | B09M000666 |
| Date of birth | 18 Mar 1969 |
| Plan | BRONZE EPO |
| Covered from | 11 Feb 2025 |
| Covered to | 4 Sep 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002828 | 23 Oct 2025 | 544.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002827 | 3 May 2025 | 789.00 | NORTHSTAR MUTUAL | Not denied | — |