RAVI SMITH
Dependent on policy B10M000405
Claims
2
Attributed to this person
Charged
469.00
Total submitted
Denied
94.82
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 | RAVI SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000405 |
| Date of birth | 13 Jun 2015 |
| Plan | BRONZE EPO |
| Covered from | 19 Aug 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 |
|---|---|---|---|---|---|
| CLM0001680 | 23 Jun 2025 | 271.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 94.82 |
| CLM0001679 | 26 Mar 2025 | 198.00 | CASCADE CARE | Not denied | — |