HENRY SMITH
Subscriber on policy B02M000463
Claims
2
Attributed to this person
Charged
959.00
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 | HENRY SMITH |
| Role on the policy | Subscriber |
| Policy | B02M000463 |
| Date of birth | 19 Nov 1988 |
| Plan | SILVER HMO |
| Covered from | 22 Oct 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 |
|---|---|---|---|---|---|
| CLM0001981 | 13 Mar 2026 | 185.00 | CASCADE CARE | Not denied | — |
| CLM0001982 | 2 Jan 2025 | 774.00 | CASCADE CARE | Not denied | — |