AMARA SMITH
Dependent on policy B03M000649
Claims
3
Attributed to this person
Charged
2,073.00
Total submitted
Denied
702.00
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 | AMARA SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000649 |
| Date of birth | 4 Dec 2006 |
| Plan | PLATINUM PPO |
| Covered from | 19 Jan 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 |
|---|---|---|---|---|---|
| CLM0002700 | 11 Sep 2025 | 702.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 702.00 |
| CLM0002699 | 20 Jun 2024 | 715.00 | CASCADE CARE | Not denied | — |
| CLM0002701 | 2 Jun 2024 | 656.00 | CASCADE CARE | Not denied | — |