KEVIN SMITH
Subscriber on policy B02M000715
Claims
2
Attributed to this person
Charged
926.00
Total submitted
Denied
292.00
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 | Subscriber |
| Policy | B02M000715 |
| Date of birth | 26 Aug 1978 |
| Plan | GOLD PPO |
| Covered from | 2 Apr 2025 |
| Covered to | 17 Nov 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 |
|---|---|---|---|---|---|
| CLM0003003 | 20 Nov 2025 | 292.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 292.00 |
| CLM0003002 | 30 Jul 2025 | 634.00 | CASCADE CARE | Not denied | — |