UMA SMITH
Dependent on policy B05M000388
Claims
3
Attributed to this person
Charged
2,041.00
Total submitted
Denied
1,380.00
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 | UMA SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000388 |
| Date of birth | 8 Dec 1999 |
| Plan | GOLD PPO |
| Covered from | 27 Feb 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 |
|---|---|---|---|---|---|
| CLM0001652 | 29 Mar 2025 | 490.00 | CASCADE CARE | CARC 18 · DUPLICATE | 490.00 |
| CLM0001650 | 20 Oct 2024 | 661.00 | CASCADE CARE | Not denied | — |
| CLM0001651 | 24 Sep 2024 | 890.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 890.00 |