NADIA SMITH
Subscriber on policy B01M000288
Claims
1
Attributed to this person
Charged
846.00
Total submitted
Denied
846.00
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 | NADIA SMITH |
| Role on the policy | Subscriber |
| Policy | B01M000288 |
| Date of birth | 3 Jan 2000 |
| Plan | PLATINUM PPO |
| Covered from | 20 Dec 2024 |
| Covered to | 18 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001253 | 3 May 2025 | 846.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 846.00 |