NADIA SMITH
Dependent on policy B05M000585
Claims
3
Attributed to this person
Charged
1,504.00
Total submitted
Denied
180.80
1 denied claims
Patient responsibility
76.80
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 | NADIA SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000585 |
| Date of birth | 11 May 2018 |
| Plan | BRONZE EPO |
| Covered from | 4 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 76.80 |
| Total | 76.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002494 | 8 Apr 2026 | 512.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002495 | 18 Oct 2024 | 516.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 180.80 |
| CLM0002496 | 24 Jun 2024 | 476.00 | MERIDIAN HEALTH PLAN | Not denied | — |