WENDY SMITH
Dependent on policy B03M000038
Claims
3
Attributed to this person
Charged
1,520.00
Total submitted
Denied
62.17
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 | WENDY SMITH |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000038 |
| Date of birth | 10 Mar 1956 |
| Plan | BRONZE EPO |
| Covered from | 27 Sep 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 |
|---|---|---|---|---|---|
| CLM0000166 | 21 Feb 2026 | 295.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 62.17 |
| CLM0000165 | 1 Jun 2025 | 523.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000167 | 27 May 2025 | 702.00 | NORTHSTAR MUTUAL | Not denied | — |