GRACE SMITH
Dependent on policy B06M000125
Claims
3
Attributed to this person
Charged
1,279.00
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 | GRACE SMITH |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000125 |
| Date of birth | 21 Mar 2006 |
| Plan | GOLD PPO |
| Covered from | 18 Sep 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 |
|---|---|---|---|---|---|
| CLM0000622 | 30 Jul 2026 | 471.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000621 | 17 Mar 2026 | 189.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000620 | 26 Dec 2024 | 619.00 | MERIDIAN HEALTH PLAN | Not denied | — |