FIONA SMITH
Subscriber on policy B10M000093
Claims
2
Attributed to this person
Charged
1,075.00
Total submitted
Denied
572.00
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 | FIONA SMITH |
| Role on the policy | Subscriber |
| Policy | B10M000093 |
| Date of birth | 15 Sep 1957 |
| Plan | BRONZE EPO |
| Covered from | 23 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 |
|---|---|---|---|---|---|
| CLM0000387 | 24 Apr 2026 | 503.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000388 | 4 Dec 2025 | 572.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 572.00 |