UMA SMITH
Dependent on policy B04M000380
Claims
2
Attributed to this person
Charged
444.00
Total submitted
Denied
308.00
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 | UMA SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000380 |
| Date of birth | 14 Jan 1985 |
| Plan | SILVER HMO |
| Covered from | 14 Apr 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001626 | 12 Apr 2026 | 308.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 308.00 |
| CLM0001625 | 24 May 2025 | 136.00 | MERIDIAN HEALTH PLAN | Not denied | — |