UMA SMITH
Dependent on policy B04M000814
Claims
3
Attributed to this person
Charged
804.00
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 | UMA SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000814 |
| Date of birth | 15 Sep 2017 |
| Plan | SILVER HMO |
| Covered from | 14 Feb 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 |
|---|---|---|---|---|---|
| CLM0003549 | 2 Jun 2026 | 140.00 | CASCADE CARE | Not denied | — |
| CLM0003547 | 17 Oct 2025 | 349.00 | CASCADE CARE | Not denied | — |
| CLM0003548 | 5 Mar 2025 | 315.00 | CASCADE CARE | Not denied | — |