TOMAS JOHNSON
Dependent on policy B06M000748
Claims
3
Attributed to this person
Charged
1,735.00
Total submitted
Denied
1,735.00
3 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 | TOMAS JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000748 |
| Date of birth | 2 Nov 1973 |
| Plan | SILVER HMO |
| Covered from | 14 May 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 |
|---|---|---|---|---|---|
| CLM0003324 | 28 May 2026 | 674.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 674.00 |
| CLM0003325 | 27 Dec 2025 | 626.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 626.00 |
| CLM0003326 | 10 Sep 2025 | 435.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 435.00 |