RAVI SMITH
Subscriber on policy B05M000129
Claims
2
Attributed to this person
Charged
272.00
Total submitted
Denied
272.00
2 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 | RAVI SMITH |
| Role on the policy | Subscriber |
| Policy | B05M000129 |
| Date of birth | 10 Jan 1962 |
| Plan | PLATINUM PPO |
| Covered from | 4 Jul 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 |
|---|---|---|---|---|---|
| CLM0000539 | 5 Feb 2026 | 95.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 95.00 |
| CLM0000538 | 4 Jan 2025 | 177.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 177.00 |