KEVIN SMITH
Dependent on policy B02M000347
Claims
3
Attributed to this person
Charged
1,426.00
Total submitted
Denied
551.00
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 | KEVIN SMITH |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000347 |
| Date of birth | 15 Apr 1958 |
| Plan | SILVER HMO |
| Covered from | 4 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 |
|---|---|---|---|---|---|
| CLM0001486 | 7 May 2026 | 646.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001484 | 8 Oct 2025 | 229.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001485 | 15 Dec 2024 | 551.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 551.00 |